前頭洞炎より硬膜下膿瘍を形成し失語症をきたした1症例

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A 13-year-old boy came to hospital on Septe- mber 12, 1963 complaining of fever, headache, nausea and vomitting. Upon examination, his left eyelid was swollen rigidity of the neck and the pathologic reflex was positive. Lumbar puncture revealed the cloudy spinal fluid, the pressure of 200mm (water), and the cell count 270/3. In the Ist operation, the dura was seen to be exposed on the posterior wall of his left frontal sinus. When this was cut, greyish pus oozed out, and was washed out Energetic chemotherapy, and continuous drainage of the cisterna lumbalis was carried out. He, however, continued to have fever, and the 2nd operation was performed on September 18. Purulent fluid accumulated in the middle cra- nial fossa. The patient returned to nearly normal condition for a time, but on November, he was affected with occaisional convulsions and the motor aphasia gradually turned to sensory. It was suspected, therefore, that the cerebral abscess was the cause, and his angiogram was sur- veyed on March 19, 1964 with a result that a space occupying view was seen on the left-parieto- temporal region. Craniotomy was under-taken and an abscess the size of an egg was seen directly under the dura, and was diagnosed as subdural abscess. Subsequent improvemeut of the patients cond- ition was seen, and is at present physically fit, except for slightly noticeable intelligence degen- eracy.