慢性硬膜下血肿钻孔引流术后硬膜下脓肿形成的治疗

Treatment of subdural abscess following burr hole drainage for chronic subdural hematoma

摘要:

目的 慢性硬膜下血肿术后并发硬膜下脓肿极为罕见，治疗方式多为再次置管引流，而选择开颅治疗极少，本文将对其开颅治疗进行讨论。方法 回顾报道开颅手术治疗的两例慢性硬膜下血肿钻孔引流术后并发硬膜下脓肿的病例。结果 两例病人预后均较好，未残留明显的神经系统受损体征。结论 硬膜下脓肿术前的影像学评估十分重要，手术方式是选择再次钻孔引流还是开颅手术需依据术前影像学特征来合理选择，静脉应用敏感抗生素一定要足量、全程。

Abstract:

Objective The development of subdural abscess following burr hole drainage for chronic subdural hematoma is very rare, and another drainage is usually performed instead of craniotomy. We will discuss the efficacy of craniotomy.Methods We report two cases of subdural abscess following burr hole drainage for chronic subdural hematoma, who were treated by craniotomy in our department.Results We report two cases of subdural abscess following burr hole drainage for chronic subdural hematoma, who were treated by craniotomy in our department.Conclusions Both cases achieved good prognosis, without obvious signs and symptoms of nervous system damage. Conclusions Preoperative imaging evaluation is vital to patients with subdural abscess, and we can select another drainage or craniotomy based on the preoperative imaging features. Antibiotics can be given intravenously at an enough dose.