Kurlan R, Griggs R C
Arch Neurol. 1983 Apr;40(4):209-12. doi: 10.1001/archneur.1983.04050040039005.
Two patients with cyanotic congenital heart disease (CHD) and erythremia were seen for abrupt onset of focal neurologic deficits and/or seizure without signs of infection or increased intracranial pressure. Clinical features and initial computed tomography (CT) in both cases suggested stroke. Subsequent CT scans demonstrated cerebral abscess, proved at operation. Review of records of patients with CHD at the University of Rochester (NY) Medical Center from 1965 to 1981 disclosed 12 cases with brain abscess but only two cases with aseptic cerebral infarction. All but one patient with abscess were cyanotic. One third of patients with abscess had a clinical picture suggesting stroke. Clinical or radiologic features of half the cases indicated that cerebral infarction may have led to abscess formation. Diagnosis of brain abscess and immediate antibiotic therapy should be strongly considered in patients with cyanotic CHD who suffer a suspected cerebral infarction.
两名患有青紫型先天性心脏病（CHD）和红细胞增多症的患者，出现局灶性神经功能缺损和/或癫痫发作，起病突然，无感染迹象或颅内压升高。两例患者的临床特征和初始计算机断层扫描（CT）均提示为中风。随后的CT扫描显示为脑脓肿，手术证实。回顾纽约罗切斯特大学医学中心1965年至1981年CHD患者的记录，发现12例脑脓肿病例，但无菌性脑梗死仅2例。除1例脓肿患者外，其余均为青紫型。三分之一的脓肿患者临床表现提示中风。半数病例的临床或影像学特征表明，脑梗死可能导致了脓肿形成。对于疑似脑梗死的青紫型CHD患者，应强烈考虑脑脓肿的诊断并立即进行抗生素治疗。
