Stereotactic Management of Bacterial Brain Abscesses
Stereotactic Management of Bacterial Brain Abscesses
复制标题
细菌性脑脓肿的立体定向治疗
DOI：
10.1017/s0317167100039159
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
R. Tasker
中科院分区：
文献类型：
--
作者：
S. Shahzadi;A. Lozano;M. Bernstein;A. Guha;R. Tasker
摘要：背景：CT和MR引导的立体定向技术在脑脓肿的治疗中取得了良好的效果。我们回顾了1986年至1993年连续20例患者28个脑脓肿的立体定向治疗结果。方法：大脑半球脓肿13例，小脑脓肿12例，脑桥脓肿2例，丘脑脓肿1例。20例中有12例分离到细菌。所有患者，除了一名有结核脓肿的患者外，使用抗生素的时间都不到7周。结果：术前昏迷3例，病死率为0，17例恢复良好，3例持续轻度神经功能障碍。在多发性脑脓肿患者中，对最大的病灶进行立体定向抽吸，结合静脉注射抗生素治疗，足以使所有病灶消失。我们的两名单独使用抗生素治疗的患者出现了脓肿进展和神经功能恶化。结论：立体定向抽吸治疗脑脓肿安全、准确，联合应用抗生素治疗脑脓肿可作为首选方法。
ABSTRACT: Background: CT and MR guided stereotactic techniques have provided promising results in the management of brain abscesses. We reviewed our results of stereotactic management of brain abscesses in 20 consecutive patients with 28 abscesses from 1986 to 1993. Methods: 13 abscesses were in the cerebral hemispheres, 12 in the cerebellum, 2 in the pons and 1 in the thalamus. The bacterial organism was isolated in 12 of the 20 cases. All patients, except one who had a tuberculous abscess, were on antibiotics for less than 7 weeks. Results: Although there were 3 patients in coma before surgery, the mortality rate was zero and 17 patients had an excellent recovery with 3 patients having a persistent mild neurologic disability. Stereotactic aspiration of the largest lesion in the patients with multiple brain abscesses combined with intravenous antibiotic therapy was sufficient for the resolution of all lesions. Two of our patients treated with antibiotics alone showed abscess progression with neurologic worsening. Conclusion: Stereotactic aspiration is safe, accurate, and when combined with the appropriate antibiotics, should be considered the procedure of choice in the management of brain abscesses.