RESULTS OF SURGICAL TREATMENT OF INTRACRANIAL ABSCESS

Yıl 2016, Cilt: 18 Sayı: 3, 127 - 133, 15.12.2016

Mehmet Akgül , Veysel Burulday

https://doi.org/10.24938/kutfd.271083

Öz

Introduction: We
aim to present our results of surgical treatment of intracranial abscess.

Material and Methods: In
our study, between the years 2005-2016 at Kirikkale University Faculty of
Medicine, Neurosurgery department was performed. Intracranial abscess treated
with the diagnosis of 11 patients were evaluated retrospectively. Intracranial
abscess, their complaints, occurrence form of abscesses, abscesses and examined
the distribution of the settlement findings. Surgical forms applied to patients
and compared. Stereotactic aspiration or Burr-hole craniectomy from the
surgical drainage technique were excised and capsules.

Results: 11
patients were enrolled in the study. The ages of the patients ranged from 11-63
years old. The average age was 33±3. Patients' complaints, according to the
incidence; 7 patients (63.6%) consciousness turbidity,4 patients (27.2%),
nausea and vomiting, to a lesser extent, headache, weakness, fever and
dizziness complaints. Abscess localization of the patients were generally located
in the temporal lobe. After the onset of symptoms of patients to our clinic
application period, the average 23.6±5 days. Surgery in 11 patients and 7 patients
with (63.6%) abscesses with Burr-hole to 2 craniectomy patients with abscesses
and 2 patients with capsular excision (18.1%) operations were performed.
Preoperative and postoperative radiographic Cranial Computed Tomography (CT)
was performed. As laboratory analysis in the clinical follow-up CBC, Sedim,
hsCRP levels were measured. Culture sent the abscess material during the
operation. Patients GOS (Glasgow outcome scale) score of 8 patients in 5
(72.7%), one patient in 4 (9.09%) to a patient in 2 (% 9.09) and a patient 1 (%
9.09) were calculated as points.

Conclusion: Intracranial
abscess of the surgical approach in the surgical excision of the capsule with
the aspiration of the abscess was not observed a significant difference in the
rate of GOS. In addition, post-surgical follow-up less than 2 cm in size of the
abscess, Cranial CT is not needed to follow, and CRP levels were seen in
follow-up medical treatment alone is enough.

Anahtar Kelimeler

Brain abscess, Aspiration, Craniektomy

İNTRAKRANİYAL ABSELERDE CERRAHİ TEDAVİ SONUÇLARI

Öz

Giriş: İntrakranyal apselerde cerrahi
tedavi sonuçlarımızı sunmaktır.

Gereç ve Yöntem: 2005-2016
tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Beyin ve Sinir
Cerrahisi kliniğinde intrakranial abse tanısı ile tedavi
edilen 11 olgu retrospektif olarak incelendi. Bu çalışmada, intrakranial apseli
hastaların şikâyetleri, apsenin meydana geliş şekli, apsenin yerleşimi ve
bulguların dağılımı incelendi. Hastalara uygulanan cerrahi yaklaşım şekilleri
ve sonuçları karşılaştırıldı. Cerrahi teknik olarak Stereotaksik Burr-hole'den aspirasyon veya
kraniektomi ile drenaj ve kapsül eksizyonu uygulandı.

Bulgular: Onbir hasta çalışmaya alındı.
Hastaların yaşları 11-63 yaş arasındaydı. Ortalama yaş 33±3 idi. Hastaların
şikayetleri, görülme sıklığına göre, 7 hastada (%63.6) bilinç bulanıklılığı, 4
hastada (%27.2) bulantı-kusma, daha az oranda baş ağrısı, kuvvetsizlik, ateş ve
baş dönmesi şikayetleri vardı. Hastaların abse lokalizasyonları genellikle
temporal lob yerleşimliydi. Hastaların semptomların başlaması sonrası
kliniğimize başvuru süreleri, ortalama 23.6±5 gün’dü. Cerrahi olarak 11
hastanın 7’sine (%63.6) Burr-holle ile abse drenajı, 2 hastaya kraniektomi ile
abse drenajı ve 2 hastaya kapsül eksizyonu (%18.1) operasyonu yapıldı.
Operasyon öncesi ve sonrası radyolojik olarak Kranial Bilgisayarlı Tomografi
(BT) çekildi. Klinik takipte laboratuar analizi olarak CBC, Sedimantasyon,
hsCRP düzeylerine bakıldı. Operasyon sırasında abse materyalinden kültür
gönderildi. Hastaların GOS (Glaskow outcome scala) puanlaması 8 hastada 5 (%72.7),
bir hastada 4 (%9.09), bir hastada 2 (%9.09) ve bir hastada 1 (%9.09) puan
olarak hesaplandı.

Sonuç: İntrakranial abselerin cerrahisinde uygulanan
cerrahi yaklaşımlardan abse aspirasyonu ile kapsül eksizyonu arasında GOS oranı
açısından belirgin bir fark görülmedi. Ek olarak cerrahi sonrası takiplerde apse boyutun 2 cm’in altında ise Kranial BT
takibine ihtiyaç olmadığı, medikal tedavi ve CRP düzeyi takibinin tek başına
yeterli olduğu görüldü.

Anahtar Kelimeler

Beyin apsesi, Aspirasyon, kraniyektomi

Kaynakça

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