中枢神经系统感染性脓肿

定义

脑实质、颅内或脊髓硬膜外或硬膜下间隙的局灶性化脓过程，不常见于脊髓实质。化脓过程通常与细菌感染有关，偶尔也与真菌、原生动物或寄生虫感染有关。脑脓肿最常由邻近的感染部位（耳、副鼻窦、乳突气房、牙）、颅面骨髓炎和开放性头部创伤或先前的神经外科手术引起。化脓性肺部感染、细菌性心内膜炎或其他感染部位的血液传播也可引起脑脓肿。颅内脓肿患者表现为头痛、精神状态改变、局灶性缺陷和癫痫发作的多种组合症状。可能发烧。椎管内脓肿患者表现为不同程度的瘫痪或四肢轻瘫，病变下方感觉障碍，括约肌功能改变和背痛。通过CT或MRI影像学检查即可确诊，并可通过神经外科引流培养脓肿引流物组织学检查证实。腰椎穿刺通常是禁忌症。

A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly associated with bacterial infection, and occasionally with fungal, protozoal, or parasitic infection. Brain abscesses develop most commonly by spread from a contiguous infected site (ear, paranasal sinuses, mastoid air cells, teeth), craniofacial osteomyelitis, and following open head trauma or previous neurosurgical procedure. Haematogenous spread from purulent pulmonary infections, bacterial endocarditis, or other sites of infection can also cause brain abscess. Patients with intracranial abscess present with variable combinations of headache, altered mental status, focal deficits, and seizures. Fever may be present. Patients with intraspinal abscess present with variable degrees of paraparesis or quadriparesis, sensory impairment below the level of the lesion, altered sphincter function, and back pain. The diagnosis is made by CT or MRI imaging, and may be confirmed by histological examination and culture of the abscess material following neurosurgical drainage. Lumbar puncture is usually contraindicated.

除外词 明确排除、需编到其他条目的情况

• 淋球菌性脑脓肿1A72.Y
• 大脑暗色丝孢霉病1F2F

子条目 共 8 条

• 1D03.0椎管内髓内脓肿
• 1D03.1椎管内硬膜下脓肿
• 1D03.2椎管内硬膜外脓肿
• 1D03.3颅内脓肿6
• 1D03.4椎管内硬脊膜外脓肿
• 1D03.5脊髓脓肿
• 1D03.Y其他特指部位的中枢神经系统感染性脓肿
• 1D03.Z中枢神经系统感染性脓肿，部位未特指