Svanteson B, Nordström C H, Rausing A
Department of Infectious Diseases, Malmö General Hospital, Sweden.
Acta Neurochir (Wien). 1988;94(1-2):57-65. doi: 10.1007/BF01406617.
Two groups of patients with non-traumatic focal intracranial suppurative diseases were studied retrospectively to illustrate epidemiology, clinical symptoms and therapeutic results. The first group consists of 87 patients treated for brain abscess in the Department of Neurosurgery in Lund. During the 36-year period investigated (1947-1982) marked epidemiological changes occurred. Thus otogenic abscesses, constituting 33% of the cases below the age of 30 during the first 12 years of the study, virtually disappeared. During the third 12-year period of this study a marked increase in the number of abscesses was noted. The increase was caused particularly by the number of cryptogenic abscesses amounting to 51% of the material during 1971-1982. The second group of patients consists of all patients with pre- or post-mortem diagnosed brain abscess in the city of Malmö during 1960-1981. Since during this period 85% of all persons who died in this city were subjected to post-mortem examination this material offers a unique possibility of epidemiological studies. The combined study of these two groups of patients lends no support to the view that a real increase in the number of brain abscesses has occurred. We conclude that in patients with cryptogenic brain abscess the clinical symptoms do not usually indicate the presence of an infectious disease. In the majority of these patients a correct diagnosis has presumably not been obtained until the last decade. Furthermore, the investigation confirms the view that a mortality below 10% is nowadays feasible in unselected cases of brain abscess.
对两组非创伤性局灶性颅内化脓性疾病患者进行回顾性研究，以阐明其流行病学、临床症状和治疗结果。第一组包括在隆德神经外科接受脑脓肿治疗的87例患者。在研究的36年期间（1947 - 1982年），出现了明显的流行病学变化。因此，耳源性脓肿在研究的前12年中占30岁以下病例的33%，实际上已消失。在本研究的第三个12年期间，脓肿数量显著增加。这种增加尤其由隐源性脓肿数量的增加引起，在1971 - 1982年期间，隐源性脓肿占资料的51%。第二组患者包括1960 - 1981年期间在马尔默市生前或死后诊断为脑脓肿的所有患者。由于在此期间该市85%的死亡人员接受了尸检，该资料为流行病学研究提供了独特的可能性。对这两组患者的综合研究并不支持脑脓肿数量实际增加的观点。我们得出结论，在隐源性脑脓肿患者中，临床症状通常并不表明存在传染病。在这些患者中的大多数，可能直到过去十年才得到正确诊断。此外，该调查证实了如今在未经选择的脑脓肿病例中死亡率低于10%是可行的这一观点。
