Brain abscess pocket suture

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 abscess is close to the bone window, and the capsule of the brain abscess is thicker. After aspiration and flushing of the abscess, in order to ensure the smooth flow, a bag-shaped suture can be performed. 2. In the removal of brain abscess, it is found that the capsule is not strong enough, and when the complete resection is difficult, it can be changed into a bag-shaped suture. Contraindications 1. Multi-atrial brain abscess. 2. Brain abscess broke into the ventricles. Preoperative preparation Apply antibiotics as early as possible, and choose the procedure, incision and drilling position. Surgical procedure 1. Incision selection, skull drilling, dural incision and puncture and pus are equivalent to brain abscess drainage. 2. The abscess is superficial, and the capsule has a certain thickness. After cutting, aspirating and rinsing, in order to ensure the smooth flow of the drainage, the incision margin of the abscess and the dura mater or the aponeurotic aponeurosis can be sutured intermittently to open the abscess. Pocket-shaped, that is, pouch suture. In addition, during the removal of the brain abscess, it was found that the capsule was not strong enough. When the whole removal was difficult, the peeled portion could be cut open, and the bag was sutured after being sucked and washed. 3. The abscess cavity has a silicone tube with 2 to 3 side holes at the front end, and the incision is sutured. complication 1. Suppurative meningitis, ventriculitis, caused by intraoperative contamination or abscess penetration into the ventricles. 2. Abscess recurrence, due to poor drainage or premature drainage tube removal. 3. Hemiplegia, aphasia, epilepsy, etc.