<原著>CT所見を中心にしてみた脳膿瘍の臨床経過

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Fifteen cases with pyogenic brain abscess were experienced in our clinic during the last 7 years. The records of these patients were examined to evaluate the clinical stage and the result of several treatments. In 12 operative cases, diagnosis was made by fluid aspirated from the abscess. Bacteria were cultured from the fluid in 5 among these cases. In 3 other non-operative patients, diagnosis was based on computed tomographic (CT) brain scans and laboratory studies. Each volume of the brain abscess and surrounding brain edema was measured on serial CT scans to evaluate the clinical stage and the abscess evolution. In symptoms and signs, it has been thought that one of the factors contributing to mortality was the level of consciousness. In this study, the disturbance of consciousness did not correlate with the size of abscess, but with that of edema. The cases reported here were divided into 3 groups according to the volume of abscess and of edema on initial CT scans. The cases of group A had small surrounding edema (<50ml ), the cases of group B had large edema (>50ml) and small abscess (<25ml), and the cases of group C had large edema and large abscess (>25ml). The group A had slight change in the clinical status and the size of edema, but the others had severe change. Three phase changes in edema size were seen in the group B regardless of therapeutic modalities ; showing almost constant increase in first 2 weeks, great decrease in second 2 weeks and moderate decrease following these 4 weeks. In the group C, however, these phases were seen only in early operation cases. We consider that these three phases may correlate with the Britt's abscess stage ; cerebritis, early capsule formation and late capsule formation, respectively. Thus it is concluded that the evaluation of surrounding brain edema may provide an indicator of the abscess stage and be useful in selecting the appropriate treatment for patients with brain abscess.
近畿大学の論文
1988-06-25

<原著>CT所見を中心にしてみた脳膿瘍の臨床経過

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