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眼旁动脉瘤血管内栓塞术后脑脓肿:病例报告及文献复习

Cerebral abscesses after endovascular coiling of a paraophthalmic aneurysm: Case report and review of the literature.

作者信息

Fish Charles, Wilson David, Chen Biyi, Yin Charlotte

机构信息

Department of Neurosurgery, Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, New South Wales 2050, Australia.

Department of Neurosurgery, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, New South Wales 2010, Australia.

出版信息

Surg Neurol Int. 2018 Dec 13;9:252. doi: 10.4103/sni.sni_189_18. eCollection 2018.

Abstract

BACKGROUND

Intracranial infections are a rare complication of therapeutic neuroendovascular procedures.

CASE DESCRIPTION

We present a case of a 72-year-old female with multiple unilateral cerebral hemisphere abscesses after endovascular embolization of a right paraophthalmic aneurysm and also provide a comprehensive review of the literature on cerebral abscesses following neurovascular embolization.

CONCLUSION

Infection following coil embolization of cerebral aneurysm is rare. However, it is likely to increase in the setting of increased used of neuroendovascular techniques in the future. Therefore, we suggest that extreme care is taken to ensure proper asepsis during embolization, and a high index of suspicion is maintained in patients with predisposing characteristics (large hemorrhage, ischemia, recurrent endovascular procedures, right-to-left shunt, and concomitant infection). Given the fact that the majority of abscesses occurred in patients who have had ruptured aneurysms, we suggest consideration is given to prophylactic intraprocedural intravenous antibiotics use as seen with open aneurysm treatment.

摘要

背景

颅内感染是治疗性神经血管介入手术罕见的并发症。

病例描述

我们报告一例72岁女性,在右侧眶旁动脉瘤血管内栓塞术后出现多个单侧脑半球脓肿,并对神经血管栓塞术后脑脓肿的文献进行全面综述。

结论

脑动脉瘤弹簧圈栓塞术后感染罕见。然而,未来随着神经血管介入技术使用的增加,其发生率可能会上升。因此,我们建议在栓塞过程中要格外小心以确保适当的无菌操作,对于具有易感特征(大出血、缺血性、反复血管内手术、右向左分流和合并感染)的患者要保持高度警惕。鉴于大多数脓肿发生在动脉瘤破裂的患者中,我们建议考虑像开放性动脉瘤治疗那样术中预防性使用静脉抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c26/6302554/aeb2f831e56a/SNI-9-252-g001.jpg

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