脑深部电刺激器再植入术后脑脓肿1例报告并文献复习

Brain abscess after deep brain stimulation re-implantation: a case report and literature review

目的 探讨帕金森病患者脑深部电极再植入术后发生脑脓肿的临床特点及治疗措施。方法 回顾性分析中南大学湘雅医院神经外科2020年6月收治的1例在脑深部电极再植入术后发生脑脓肿的帕金森患者的临床资料,并对相关文献进行复习。结果 因第一次植入术后皮下感染,所有植入物均被移除,并接受敏感抗生素治疗。4个月后,再次行植入手术。患者术后出现严重颅内脓肿,再次取出植入物,并接受立体定向脓肿穿刺引流术及抗生素治疗,最终康复。结论 有潜在感染风险的患者在脑深部电极再次植入手术前,需进行足量足疗程的抗感染治疗,并进行全面的感染指标检查,以明确感染是否已完全消除。

Objective To explore the clinical features and treatment of the patient with serious intracerebral abscess after deep brain electrode re-implantation.Methods The clinical data of a Parkinson's patient with brain abscess after deep brain electrode implantation admitted in Department of Neurosurgery,Xiangya Hospital,Central South University in June 2020 were retrospectively analyzed,and the related literature was reviewed.Results Due to subcutaneous infection after the first implantation,all implants were removed and the patient received sensitive antibiotic treatment.Four months later,the patient underwent another implantation surgery.After the surgery,the patient developed severe intracranial abscess and had to remove the implant again.The patient underwent stereotactic abscess puncture and drainage surgery and antibiotic treatment,ultimately recovered.Conclusions Patients with potential risk of infection need to undergo sufficient and long-term anti infection treatment before re-implantation of deep brain electrode,and undergo comprehensive infection indicator tests to determine whether the infection has been completely eliminated.