被殻出血部に続発した脳膿瘍の1例

Putaminal abscess occurring at the site of hemorrhage:a case report

I．はじめに

　脳内血腫部に脳膿瘍が続発した症例報告は極めて少ない．本稿では，右被殻出血に対して保存的加療を行っていたところ，約2カ月後に同部に膿瘍が続発し，定位的排膿術にて良好な経過をみた1症例を報告する．

Brain abscesses following stroke have been reported only rarely. We presented a case of putaminal abscess following putaminal hemorrhage. The patient was admitted to our hospital because of acute onset of left hemiplegia. The size of the hematoma was medium and the patient was conservatively treated. In about two months after the ictus, he became intermittently febrile and laboratory examinations suggested the presence of general infections including meningitis.

Meanwhile, CT and MRI revealed clearly abscess formation at the site of the hematoma with remarkable brain edema. Cerebrospinal fluid analysis showed the findings of meningitis. On diagnosis of brain abscess, stereotactic exploration was performed and pus mixed with old blood was aspirated. Bacteriological study of the specimen demonstrated Morganella morganii. Post-operative course was uneventful and the abscess cavity gradually subsided following drainage and irrigation of the abscess cavity.