Prusty G K
Department of Neurosurgery, Bokaro General Hospital, Bokaro Steel City.
Indian J Pediatr. 1993 Jan-Feb;60(1):43-51. doi: 10.1007/BF02860506.
Sixty cases of brain abscesses in patients with cyanotic heart disease is reported. Forty four (73.3%) belonged to pediatric age group. There was only single case of infratentorial abscess located in the cerebellar paravermian region. The abscesses were multiloculated in 42%, multiple in 10% and solitary in 48% cases. Streptococci was the commonest (77%) micro-organism isolated from pus culture. Forty eight patients were treated by aspiration through twist drill, 7 patients conservatively and 5 had primary excision of abscesses. Forty four patients improved in their neurological status, three had fixed neurological deficits and 5 patients deteriorated further. There were 8 deaths. Complication like cyanotic spells was recorded in 17% cases treated by aspiration. None of the patients treated by twist drill aspiration had seizure. It is suggested that aspiration of abscesses through twist drill hole and antibiotic therapy could be the treatment of choice. Vascular slowing in a localised area resulting in infraction and thus preparing the focus for abscess formation is the possible mechanism in the evolution of these abscesses.
本文报告了60例患有紫绀型心脏病的脑脓肿患者。其中44例（73.3%）属于儿童年龄组。仅1例幕下脓肿位于小脑蚓旁区。42%的脓肿为多房性，10%为多发性，48%为单发性。链球菌是脓培养中最常见的微生物（77%）。48例患者采用钻颅抽吸治疗，7例保守治疗，5例进行了脓肿一期切除。44例患者神经功能状态改善，3例遗留固定神经功能缺损，5例病情进一步恶化。8例死亡。17%接受抽吸治疗的患者出现了如紫绀发作等并发症。钻颅抽吸治疗的患者均未发生癫痫。提示钻颅抽吸脓肿及抗生素治疗可能是首选治疗方法。局部血管血流缓慢导致梗死，进而为脓肿形成准备病灶，可能是这些脓肿演变的机制。
