Brain Abscess Drainage

The so-called brain abscess refers to those caused by bacteria. All purulent bacteria invade the brain, causing purulent inflammation of the brain, and localized the formation of the abscess, called brain abscess. Its incidence accounts for about 1.3% of the total number of inpatients in neurosurgery. Brain abscesses occur mostly on the screen, rare under the curtain, can occur at any age, but the majority of youth. The path of infection of brain abscess is: 1 otogenic brain abscess, which occurs mostly in temporal lobe, followed by cerebellum, and occasionally in frontal lobe, parietal lobe and occipital lobe. It is more common in chronic otitis media, and most brain abscesses are Single hair, a small number can be multiple or multiple atrial. 2 blood-borne brain abscess (also known as metastatic brain abscess), is the infection of the brain away from the brain after the embolism fell off with the blood to the brain to form an abscess. The embolus can enter the white matter of the brain through the arterial, venous or spinal venous plexus, which in turn forms an abscess. 3 traumatic brain abscess, foreign body contaminated by craniocerebral firearms and broken bone pieces directly into the brain, or in the usual open injury, skull base fracture, bacteria through the wound or air sinus directly into the brain to form an abscess. 4 nasal brain abscess, mostly caused by frontal sinusitis, ethmoid sinusitis, maxillary sinusitis and sphenoid sinusitis, but less common. 5 cryptogenic brain abscess. Since the original infection is hidden or disappeared, the source of the infection is difficult to identify. Strictly speaking, it should be a blood-borne brain abscess. Clinically, it is often hospitalized by brain tumors, confirmed by surgery or surgery. According to the speed and severity of the disease, brain abscess can be divided into acute brain abscess (burdenous brain abscess) and chronic brain abscess. Clinically, the formation of brain abscess is divided into three phases, namely, acute encephalitis, suppuration and abscess formation. Because of the sooner or later, the size and location of brain abscess formation, the symptoms often vary widely. In order to diagnose early, in the inquiry of the medical history, attention should be paid to the presence or absence of suppurative lesions and the corresponding signs and symptoms. In time, the X-ray, CT and MRI examinations can be performed in time to provide accurate positioning and qualitative basis, and diagnosis. It is not difficult. Once the brain abscess is diagnosed, the main treatment is surgery, and at the same time systemic antibiotics and supportive therapy. General surgical methods include: brain abscess puncture, drainage and resection. Usually, most advocate the use of simple and small damage to brain tissue, if not effective, then consider surgical resection. Treatment of diseases: brain abscess Indication 1. The clinical diagnosis has been confirmed, and the brain abscess is deep or close to the functional area. 2. Brain abscess caused by open injury, poor drainage or temporary closure of the leak, and increased intracranial pressure. 3. Critically ill patients or children with brain abscess, can not tolerate major surgery, feasible puncture abscess drainage. 4. Otogenic brain abscess, dural necrosis is found during mastoid surgery, and drainage can be performed in the mastoid. 5. The course of the disease is short, and the formation of the abscess wall seen in imaging is still thin. It is estimated that the abscess is easily ruptured in the abscess resection, and the puncture drainage can be performed first. Contraindications 1. Brain abscess has penetrated the ventricle wall, only abscess drainage is used, it is difficult to save the patient. 2. Multi-atrial abscess is not easy to drain the heal. Preoperative preparation Determine the formation of the abscess and the wall of the capsule and choose the exact surgical procedure. Surgical procedure Incision Select the distance abscess recently and avoid the important functional area of the brain to make a 3~4cm long straight incision, stop bleeding, and open the incision with the skin automatic retractor, cut the skull periosteum, reveal the skull. 2. Skull drilling After drilling the skull, the dura mater is revealed, and the skull is covered with bone wax to stop bleeding. 3. Dural incision The dura mater was used to cut the dura mater, and the cerebral cortical blood vessels were coagulated. The pericardium was properly protected by the brain cotton, and then the abscess was puncture. 4. Brain abscess puncture Take the brain needle according to the predetermined puncture depth. If there is resistance, a little force can break through the wall of the abscess. At this time, the brain needle is fixed, the needle core is pulled out, and the 2ml empty needle is attached, and the suction is slow. The specimen is sent to the bacteria culture, and the large-capacity empty needle is used to absorb the pus, and the antibiotic physiological saline solution is injected into the abscess cavity, and the rinse is repeated. The double cannula that was drained was placed in the abscess and sutured and fixed on the scalp for postoperative drainage. When the abscess is reduced or disappeared, the drainage tube is gradually shortened or even removed. 5. Incision suture After completely stopping bleeding, the drainage tube was fixed to the skin edge, the incision was sutured in layers, and the drainage tube was connected to the disinfection drainage bag for continuous drainage. complication 1. Incision infection, osteomyelitis, epidural and subdural abscess. 2. Suppurative meningitis, ventriculitis. 3. Systemic sepsis or recurrence of brain abscess. 4. Hemiplegia, aphasia, epilepsy, etc.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.