Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Prodromal signs and clinical factors influencing outcome in patients with intraventricular rupture of purulent brain abscess
Autore:
Takeshita, M; Kawamata, T; Izawa, M; Hori, T;
Indirizzi:
Tokyo Womens Med Univ, Dept Neurosurg, Neurol Inst, Shinjuku Ku, Tokyo 1628666, Japan Tokyo Womens Med Univ Tokyo Japan 1628666 njuku Ku, Tokyo 1628666, Japan
Titolo Testata:
NEUROSURGERY
fascicolo: 2, volume: 48, anno: 2001,
pagine: 310 - 316
SICI:
0148-396X(200102)48:2<310:PSACFI>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
MANAGEMENT; PERIOD;
Keywords:
brain abscess; forewarning signs; infection; intraventricular rupture;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Takeshita, M Tokyo Womens Med Univ, Dept Neurosurg, Neurol Inst, Shinjuku Ku, Kawada Cho 8-1, Tokyo 1628666, Japan Tokyo Womens Med Univ Kawada Cho 8-1 Tokyo Japan 1628666 pan
Citazione:
M. Takeshita et al., "Prodromal signs and clinical factors influencing outcome in patients with intraventricular rupture of purulent brain abscess", NEUROSURGER, 48(2), 2001, pp. 310-316

Abstract

OBJECTIVE: To elucidate prodromal signs and clinical factors influencing the prognosis in patients with intraventricular rupture of brain abscess (IVROBA) to prevent and manage this catastrophic condition. METHODS: In this study, 33 consecutive patients with IVROBA diagnosed by computed tomography (CT) were treated. Basic and therapeutic parameters wereevaluated as independent predictive factors of a poor prognosis by using univariate analysis. The factors were statistically analyzed based on the interval between initial symptoms and IVROBA. RESULTS: Patients with a good outcome were younger (<21 yr old) (P < 0.003) and had fewer complications after IVROBA (P < 0.03). For the most part, these patients had undergone aspiration for brain abscess with ventricular drainage combined with the immediate administration of appropriate intravenous and intrathecal antibiotics (P < 0.02). In just a short time, abscesses located in the parieto-occipital region ruptured into the ventricle (P < 0.004), and those with nonsterile cultures (P < 0.01) developed into IVROBA. Just before IVROBA, patients had severe headaches, signs of meningeal irritation, and a rapidly deteriorating clinical condition within 10 days after the signs of meningeal irritation developed. A CT scan obtained before IVROBA ascertained localized enhancement of the ventricular wall adjacent to the abscess. CONCLUSION: Our findings suggest that signs of meningeal irritation and localized enhancement of the ventricular wall adjacent to the abscess, as observed on CT scans, preceded IVROBA. To decrease the mortality rate associated with purulent brain abscesses, signs forewarning of IVROBA should be recognized, and aggressive management of IVROBA should be initiated. Aggressive CT-guided aspiration of deep-seated abscesses, particularly in the parieto-occipital region, at the time forewarning signs of IVROBA are observed lead to the prevention of IVROBA and an improvement in outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 09:56:04