Sainte-Rose C, Roux F X, Renier D, Pierre-Kahn A, Hirsch J F
Neurochirurgie. 1982;28(1):33-40.
The authors report on 13 cerebral abscesses developed in children with cyanogenic heart disease. The abscesses have been treated by one or several punctures and by a general antibiotherapy adjusted to the germ when it was isolated. C.T. Scan and epidural Intra-cranial pressure monitoring have defined the Therapeutic tactics. The mortality rate is 7.7%. 60% of the survivors lead a normal life; 40% are mentally retarded; however this mental retardation is not directly related to the abscess; it appears to be a consequence of the cyanogenic cardiopathy. The neurological sequelae are one epilepsy and two visual defects compatible with normal life. Successive C.T. Scans in the months following treatment have shown the progressive disappearance of the abscess membranes. The conclusions of this study are under antibiotherapy, it is better to tap abscesses than to remove them and that their prophylaxy is the suppression of the shunt responsible of the cyanosis.
作者报告了13例患有先天性心脏病的儿童发生脑脓肿的情况。这些脓肿通过一次或多次穿刺以及根据分离出的病菌进行的全身抗生素治疗。计算机断层扫描(CT扫描)和硬膜外颅内压监测确定了治疗策略。死亡率为7.7%。60%的幸存者过着正常生活;40%智力发育迟缓;然而这种智力发育迟缓与脓肿并无直接关系;它似乎是先天性心脏病的结果。神经后遗症为一例癫痫和两例不影响正常生活的视力缺陷。治疗后数月的连续CT扫描显示脓肿包膜逐渐消失。本研究的结论是,在抗生素治疗下,穿刺引流脓肿优于切除脓肿,其预防措施是消除导致发绀的分流。