Harlé J R, Vincentelli F, Peragut J C, Weiller P J, Grisoli F
Clinique médicale B, Hôpital de la Timone, Marseille.
Rev Med Interne. 1988 Sep-Oct;9(4):369-76. doi: 10.1016/s0248-8663(88)80136-x.
Although treatment with antibiotics and computerized tomography (CT) of the brain have considerably improved the prognosis of intracranial purulent collections, brain abscess remains a lethal disease in about one out of ten cases. We present a series of 41 brain abscesses diagnosed between 1976 and 1986 and treated surgically. The clinical signs were more often neurological than infectious. Among the exploratory methods, only CT has a real diagnostic value. Treatment is both medical and surgical. Simple aspiration seems to have the triple advantage of producing prompt and effective decompression of brain tissue, enabling the pathogen(s) to be isolated so that the appropriate antibiotic can be chosen, and being a repeatable and little traumatic procedure with less sequelae than surgical excision.
尽管使用抗生素治疗和脑部计算机断层扫描(CT)已显著改善了颅内脓性病灶的预后,但脑脓肿在约十分之一的病例中仍然是致命疾病。我们报告了1976年至1986年间诊断出并接受手术治疗的一系列41例脑脓肿。临床症状更多表现为神经症状而非感染症状。在各种探查方法中,只有CT具有真正的诊断价值。治疗包括药物治疗和手术治疗。单纯穿刺抽吸似乎具有三重优势:能迅速有效地使脑组织减压,可分离出病原体以便选择合适的抗生素,并且是一种可重复且创伤小、后遗症比手术切除少的操作。