Beller A J, Sahar A, Praiss I
J Neurol Neurosurg Psychiatry. 1973 Oct;36(5):757-68. doi: 10.1136/jnnp.36.5.757.
Eighty-nine cases of brain abscess, diagnosed over a period of 30 years, are reviewed. The incidence of this disease did not decline throughout the period. Abscesses of ear and nose origin constituted the largest group (38%). Postoperative abscesses seem to have increased in incidence, presumably due to routine postoperative antibiotic treatment. Antibiotics were possibly responsible for the suppression of signs of infection in 45% of the patients, who presented as suffering from a space-occupying lesion. The most accurate diagnostic tool was angiography, which localized the lesion in 90% and suggested its nature in 61%. Brain scan may prove as satisfactory. Staphylococcus was cultured in about two-thirds of the cases. Mortality seemed to decrease concomitantly with the advent of more potent antibiotics. The treatment of choice in terms of both mortality and morbidity seemed to be enucleation after previous sterilization. The hazards of radical surgery should be taken into consideration.
回顾了30年间确诊的89例脑脓肿病例。在这一时期，该病的发病率并未下降。耳源性和鼻源性脓肿占最大比例（38%）。术后脓肿的发病率似乎有所增加，可能是由于术后常规使用抗生素治疗。在45%表现为占位性病变的患者中，抗生素可能抑制了感染迹象。最准确的诊断工具是血管造影，它能定位90%的病变，并能提示61%病变的性质。脑扫描可能同样令人满意。约三分之二的病例培养出葡萄球菌。随着更有效的抗生素问世，死亡率似乎随之下降。就死亡率和发病率而言，首选的治疗方法似乎是在先行灭菌后摘除脓肿。应考虑根治性手术的风险。
