Stroobandt G, Zech F, Thauvoy C, Mathurin P, de Nijs C, Gilliard C
Acta Neurochir (Wien). 1987;85(3-4):138-47. doi: 10.1007/BF01456110.
Sixteen patients, with a total of 18 abscesses, were treated by aspiration and systemic antibiotic therapy, to which antiepileptic prophylaxis and corticosteroids were added. Diagnosis of the abscesses and monitoring of their evolution relied principally upon computed tomography; this technique was also used per-operatively when aspirating small abscesses. Bacteriological examinations were positive in all our cases and a polymicrobial flora was found in half of these. One or, eventually, two aspirations within the same week were sufficient, in most cases, to promote healing. Nevertheless, in three patients, the abscesses, however sterilized, did not show any volume reduction, probably because of adhesions to the dura mater, of a large part of the abscess surface area. One patient died from concomitant cardiac disease and one patient remained seriously disabled. Epilepsy was observed as a sequela, in six patients. This study emphasizes the role of neuroradiological and bacteriological examinations, whilst surgery may be restricted, in most cases, to a simple aspiration.
16例患者共有18个脓肿，接受了穿刺抽吸和全身抗生素治疗，并加用了抗癫痫预防药物和皮质类固醇。脓肿的诊断及其演变的监测主要依靠计算机断层扫描；在抽吸小脓肿时，该技术也用于术中。我们所有病例的细菌学检查均为阳性，其中一半发现有多种微生物菌群。在大多数情况下，同一周内进行一次或最终两次抽吸就足以促进愈合。然而，有3例患者的脓肿无论如何进行消毒处理，体积都没有缩小，可能是因为脓肿大部分表面积与硬脑膜粘连。1例患者死于合并的心脏病，1例患者仍严重残疾。6例患者出现癫痫后遗症。本研究强调了神经放射学和细菌学检查的作用，而在大多数情况下，手术可能仅限于简单的抽吸。
