乳児脳膿瘍の4例

FOUR CASES OF BRAIN ABSCESS IN INFANCY

I．はじめに

　乳児脳膿瘍は比較的まれな疾患であるが，化学療法の発達した現在なお，時に見受けられ，その死亡率は高く，救命し得ても後障害を残すことが多い。われわれは，最近3年間に1歳未満の脳膿瘍4例を経験したので，文献的考察とともに報告する。

Four cases of brain abscess in infancy were reported. Two (5 month-old male, 6 month-old female) died 12 and 14 days after the operation respectively, the other 2 (2 month-old male, 3 month-old male) were relieved but severe mental and physical retardation have remained postoperatively.

Mortality of brain abscess, particularly in infancy, is still very high and even in saved cases normal life seldom followed. For the improvement of prognosis, early treatment should be emphasized. However, as the infants with brain abscess usually develop the enlargement of their heads, misdiagnosis of "hydro-cephalus" is easily made, which prevents the early treatment. Cerebral angiography was valuable to dif-ferentiate brain abscess from congenital hydrocephalus in some occasion.

Cerebral arterial patterns of the relieved cases by the operation were very similar to those of some men-tally retarded children. This fact will suggest that cerebral angiography may have a value to explain the true cause of some kind of mental retardation.

For the treatment of severe sequelae, thickened and adhered arachnoid over unilateral hemisphere was peeled off and pial vessels were freed in a case but no satisfying result was obtained. New concept to treat these sequelae is desirable.