Braun V, Richter H P
Universität Ulm, Klinik für Neurochirurgie, Günzburg.
Zentralbl Neurochir. 1995;56(2):64-8.
Spontaneous intracranial abscesses are quite rare in western industrial countries. According to the recently published papers, each neurosurgical centre is expecting 2 to 4 cases a year. Whereas in the last three years we only operated on one or two cases a year we treated 8 cases in the first ten months of 1994. Although this remarkable increase is not statistically significant, further observations seem to be indicated. In 5 cases the origin of the abscess remained unknown. 3 patients had odontogeneous focuses, 2 middle ear and 2 pulmonary infections. One patient was operated on for spontaneous liver abscess few days before. Streptococcus was found in 9 cases, Bacteroides, Nocardia and Rhodoturola in 1 case each. For one patient no pathogen could be detected. In regard of our results, minimal invasive neurosurgical aspiration of the abscess with adjacent longterm antibiotic therapy gives a good prognosis with little morbidity. In contrast the mortality rate rises if diagnostic procedures are delayed or if the detected microorganism is highly resistant to current antibiotics.
自发性颅内脓肿在西方工业化国家相当罕见。根据最近发表的论文，每个神经外科中心每年预计有2至4例。过去三年我们每年仅处理1至2例，而在1994年的前十个月我们治疗了8例。尽管这一显著增加在统计学上不显著，但似乎仍需进一步观察。5例脓肿的起源不明。3例患者有牙源性病灶，2例有中耳感染，2例有肺部感染。1例患者在几天前因自发性肝脓肿接受了手术。9例发现链球菌，1例分别发现拟杆菌、诺卡菌和红酵母。1例患者未检测到病原体。就我们的结果而言，对脓肿进行微创神经外科穿刺抽吸并辅以长期抗生素治疗，预后良好且发病率低。相反，如果诊断程序延迟或检测到的微生物对当前抗生素高度耐药，死亡率会上升。
