Cerebral and Subdural Abscess With Spatio-temporal Multiplicity 12 Years After Initial Craniotomy for Acute Subdural Hematoma : Case Report

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著者

    • WAKUI Daisuke
    • Department of Neurosurgery, St. Marianna University Toyoko Hospital
    • NAGASHIMA Goro
    • Department of Neurosurgery, St. Marianna University Toyoko Hospital
    • TAKADA Tatsuro
    • Department of Strokology, St. Marianna University Toyoko Hospital
    • UEDA Toshihiro
    • Department of Strokology, St. Marianna University Toyoko Hospital
    • ITOH Hidemichi
    • Department of Neurosurgery, St. Marianna University School of Medicine
    • TANAKA Yuichiro
    • Department of Neurosurgery, St. Marianna University School of Medicine
    • HASHIMOTO Takuo
    • Department of Neurosurgery, St. Marianna University School of Medicine

抄録

A 34-year-old man presented with a case of subdural empyema and cerebral abscess that developed 12 years after initial neurosurgical intervention for a traffic accident in 1998. Under a diagnosis of acute subdural hematoma and cerebral contusion, several neurosurgical procedures were performed at another hospital, including hematoma removal by craniotomy, external decompression, duraplasty, and cranioplasty. The patient experienced an epileptic seizure, and was referred to our hospital in March 2010. Magnetic resonance imaging revealed a cerebral abscess extending to the subdural space just under the previous surgical field. Surgical intervention was refused and antimicrobial treatment was initiated, but proved ineffective. Surgical removal of artificial dura and cranium with subdural empyema, and resection of a cerebral abscess were performed on May 12, 2010. No organism was recovered from the surgical samples. Meropenem and vancomycin were selected as perioperative antimicrobial agents. No recurrence of infection has been observed. Postneurosurgical subdural empyema and cerebral abscess are recently emerging problems. Infections of neurosurgical sites containing implanted materials occur in 6% of cases, usually within several months of the surgery. Subdural empyema and cerebral abscess developing 12 years after neurosurgical interventions are extremely rare. The long-term clinical course suggests less pathogenic organisms as a cause of infection, and further investigations to develop appropriate antimicrobial selection and adequate duration of antimicrobial administration for these cases are needed.<br>

収録刊行物

  • Neurologia medico-chirurgica = 神経外科

    Neurologia medico-chirurgica = 神経外科 52(2), 109-112, 2012-02-15

    一般社団法人 日本脳神経外科学会

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各種コード

  • NII論文ID(NAID)
    10030127441
  • NII書誌ID(NCID)
    AN00358613
  • 本文言語コード
    ENG
  • 資料種別
    NOT
  • ISSN
    04708105
  • データ提供元
    CJP書誌  J-STAGE 
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