[P3-30] Multiple Anaerobic Streptococcal Subdural and Cerebral Abscesses Caused by Sinusitis : A Case Report
[Objectice] We study the etiology, clinical manifestation, imaging characteristics and treatment of subdural abscess complicated by brain abscess, to improve the knowledge of this disease.[Methods] A retrospective analysis and summarize of the clinical data of 1 case of subdural abscess complicated by brain abscess recently diagnosised in our hospital. [Results] A 19-year-old male patient suffered from headache for 8 days and recurrent seizures for 1 day. Head MRI revealed left frontal and parietal lobe gyrui were enlarged and brain sulci were shallow. Slightly longer T1 and T2 signals,FLAIR and DWI high signals were showed under the left frontal and parietal bone. Long T2 signals were demonstrated in bilateral maxillary sinus, ethmoid sinus, left frontal sinus. Enhanced head MRI showed edged linear enhancement. Anaerobic streptococcus was positive in the blood culturetest.Clinical diagnosis was subdural abscess, brain abscess and sinusitis. After 1 week of treatment, the reexamination of head MRI manifested the enlarged lesions.So a neurosurgery was performed to brain abscesses removal with general anesthesia. Discharge follow-up was conducted showing normality of the patient.[Conclusion] Subdural abscess and brain abscess are potentially fatal infectious diseases of the central nervous system. Early diagnosis and timely treatment are crucial for excellent prognosis. Seeking the source of the infection is necessary. Head MRI and enhanced MRI are mandatory.Surgery cannot be replaced by the antibiotics.When the abscess wall formation with the risk of brain herniation is predicted after the application of the antibiotics, early surgical intervention is critical for the treatment.
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