Monobe T, Kawai S, Takemura K, Tanaka Y, Kakizaki T, Kim Y J
Department of Neurosurgery, Osaka Prefectural Hospital, Japan.
No Shinkei Geka. 1994 Apr;22(4):363-5.
The authors report a rare complication during aspiration of a brain abscess. A 23 year-old man who had undergone surgery for empyema two months previously presented himself at our hospital complaining of headache, deterioration of activity and conscious level. An emergency computed tomography demonstrated a left frontal brain abscess. Aspiration and drainage were performed. However, this resulted in massive hematoma in and around the abscess capsule. Following craniotomy and excision of the abscess, the patient was cured. Microscopic examination of the abscess revealed the formation of a complete capsule consisting of fibroblasts and collagen fiber. In addition to this, significant neovascularization with inflammatory cells was apparent around the capsule. These findings suggest that profuse hemorrhage may occur in aspiration and drainage surgery.
作者报告了一例脑脓肿穿刺抽吸过程中的罕见并发症。一名23岁男性，两个月前因脓胸接受了手术，现因头痛、活动及意识水平恶化前来我院就诊。急诊计算机断层扫描显示左额叶脑脓肿。进行了穿刺抽吸和引流。然而，这导致脓肿包膜内及周围出现大量血肿。开颅切除脓肿后，患者治愈。对脓肿的显微镜检查显示形成了一个由成纤维细胞和胶原纤维组成的完整包膜。除此之外，包膜周围可见明显的伴有炎性细胞的显著新生血管形成。这些发现提示在穿刺抽吸和引流手术中可能发生大量出血。
