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A CLINICAL SURVERY OF ABSCESS OF THE BRAIN: (1) SPECIAL REFERENCE TO ANGIOGRAPHIC CLASSIFICATION AND TREATMENT OF ABSCESS OF THE BRAIN Mizuo Kagawa 1 , Nobuko Ogawa 1 , Toyoaki Shinohara 1 , Koichi Kitamura 1 1Department of Neurosurgery, Tokyo Women's Medical College pp.393-405
Published Date 1973/4/1
DOI https://doi.org/10.11477/mf.1406203300
  • Abstract
  • Look Inside

After antibiotic therapy has been developed, abscess of the brain seems to be under control, although mortality and morbidity of brain abscess are still high without adequate early diagnosis and treatment.

With regard to early diagnosis and treatment, several methods have been established, and it has been clarified that, the most powerful diagnostic aid is angiography, brain scan and EEG, however, brain scan and EEG could not manifest develop-mental process of the capsule of brain abscess.

In this paper, we intended to elicit the angio-graphical developmental process of the capsule of brain abscess and to establish adequate treatment according to angiographic classification of brain abscess.

In our series of 23 cases, clinical studies includ-ing angiography, clinical symptoms and patho-hystology of operative material and necropsy material are surveyed.

With regards to angiographic and pathohysto-logical classification, abscess of the brain is divided into 3 stages. The classification are as follows :

stage 1; acute stage

stage 2 ; subacute stage

stage 3 ; chronic stage

Each 3 stage has specific angiographic findings, therefore repeated angiographical study shows talkatively a clinical pathohystological process of brain abscess, and peri-capsular inflammatory process.

The treatment of abscess of the brain are still in debate. Our program of treatment of brain abscess are as follows. As to the diagnostic pro-cedure, repeated angiography is supreme and angio-graphical classification should be carried out.

In case with stage 1 of angiographical classi-fication; conservative treatments including adequatesystemic antibiotics and intravenous administration of gamma globulin, occasional use of steroid hormon and anti-hypertensive drugs such as mannitol and intrathecal administration of antibiotics.

In case of stage 2, under systemic administra-tion of antibiotics and intravenous gamma globulin, burr hole is opened and multiaspiration should be carried out and antibiotics and radio-opaque material are given into abscess cavity, and total extra-capsular extirpation of abscess should be performed in angiographical classification of stage 3.


Copyright © 1973, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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