Pradhan Anjali, Rutayisire François Xavier, Munyemana Paulin, Karekezi Claire
Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California, Los Angeles, California.
David Geffen School of Medicine, Ronald Reagan UCLA Medical Center, University of California, Los Angeles, Los Angeles, California; and.
J Neurosurg Case Lessons. 2021 Dec 13;2(24):CASE21570. doi: 10.3171/CASE21570.
Intracranial suppuration (ICS) is a rare complication that can arise from various disease processes and is composed of brain abscess, extradural empyema, and subdural empyema. Although significant progress has been achieved with antibiotics, neuroimaging, and neurosurgical technique, ICS remains a serious neurosurgical emergency. An uncommon presentation of ICS is sterile ICS, which has yet to be fully elucidated by clinicians. The authors present 2 cases of unusual sterile ICS: a sterile subdural empyema and a sterile brain abscess.
Both patients underwent surgical treatment consisting of craniotomy to evacuate the pus collection. The blood cultures from both the patients, the collected empyema, and the thick capsule from the brain abscess were sterile. However, the necrotic brain tissue surrounding the abscess contained inflammatory cells. The authors' review of the literature emphasizes the rarity of sterile ICS and substantiates the necessity for additional studies to explore this field.
Sterile ICS is a disease entity that warrants further investigation to determine appropriate treatment to improve patient outcomes. This study highlights the paucity of data available regarding sterile ICS and supports the need for future studies to uncover the etiology of sterile ICS to better guide management of this condition.
颅内化脓（ICS）是一种罕见的并发症，可由多种疾病过程引起，包括脑脓肿、硬膜外脓肿和硬膜下脓肿。尽管在抗生素、神经影像学和神经外科技术方面取得了显著进展，但ICS仍然是一种严重的神经外科急症。ICS的一种不常见表现是无菌性ICS，临床医生尚未完全阐明其情况。作者报告了2例不寻常的无菌性ICS病例：无菌性硬膜下脓肿和无菌性脑脓肿。
两名患者均接受了手术治疗，包括开颅手术以排出脓液。两名患者的血培养、收集的脓液以及脑脓肿的厚包膜均无菌。然而，脓肿周围的坏死脑组织含有炎性细胞。作者对文献的回顾强调了无菌性ICS的罕见性，并证实了进一步研究该领域的必要性。
无菌性ICS是一种需要进一步研究以确定适当治疗方法以改善患者预后的疾病实体。本研究突出了关于无菌性ICS的可用数据的匮乏，并支持未来开展研究以揭示无菌性ICS的病因，从而更好地指导该病的管理。
