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Absceso cerebral

  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 20 Aug 2025
Last updated: 23 May 2023

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presencia de factores de riesgo
  • sexo masculino
  • edad <30 años
  • meningismo
  • cefalea
  • parálisis de pares craneales
  • signo de Kernig o Brudzinski positivo
  • fiebre
  • aumento de la circunferencia de la cabeza (lactantes)
  • fontanelas abultadas (lactantes)
Полная информация

Другие диагностические факторы

  • déficit neurológico
  • papiledema
Полная информация

Факторы риска

  • sinusitis
  • otitis media
  • procedimiento/infección dental
  • meningitis
  • cirugía reciente de cabeza y cuello o neurocirugía
  • cardiopatía congénita
  • endocarditis
  • enfermedad diverticular
  • telangiectasia hemorrágica hereditaria o malformación arteriovenosa
  • diabetes mellitus
  • VIH o compromiso inmunológico
  • consumo de drogas ilícitas por vía intravenosa
  • enfermedad granulomatosa crónica
  • hemodiálisis
  • prematuridad en el nacimiento
  • fibrosis quística
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • hemograma completo (HC)
  • velocidad de sedimentación globular (VSG) sérica
  • proteína C-reactiva sérica
  • TP sérico, TTP e INR
  • hemocultivo
  • resonancia magnética (IRM) con contraste
  • tomografía computarizada (TC) de cabeza con y sin contraste
  • ultrasonido de cabeza (lactantes)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • título de toxoplasma sérico
  • espectroscopia por resonancia magnética (ERM)
  • punción lumbar (PL) con análisis de líquido cefalorraquídeo (LCR)
  • tomografía computarizada (TC) de tórax, abdomen y pelvis
  • gammagrafía ósea
  • mamografía
Полная информация

Алгоритм лечения

Начальные

absceso cerebral presunto

Острый

etiología bacteriana sospechada o confirmada

etiología fúngica confirmada

etiología parasitaria sospechada o confirmada

absceso cerebral criptogénico

Составители

Авторы

Walter A. Hall, MD, MBA

Professor

Department of Neurosurgery

SUNY Upstate Medical University

Syracuse

NY

Раскрытие информации

WAH is an author of a number of references cited in this topic.

Выражение благодарностей

Dr Walter A. Hall would like to gratefully acknowledge Dr Peter D. Kim, a previous contributor to this topic. PDK declares that he has no competing interests.

Рецензенты

Stephen Haines, MD

Professor and Head

Department of Neurosurgery

University of Minnesota

Minneapolis

MN

利益声明

SH and WAH were colleagues on a faculty of the University of Minnesota between 1991 and 1997 and again between 2004 and 2006. They have coauthored articles on neurosurgical infection.

Sabrina Ravaglia, MD, PhD

Staff Physician

Department of Neurological Sciences

Institute of Neurology C. Mondino

Pavia

Italy

利益声明

SR declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology. 2014 Mar 4;82(9):806-13. 摘要

Hall WA, Truwit CL. The surgical management of infections involving the cerebrum. Neurosurgery. 2008 Feb;62(2 suppl):519-30. 摘要

Goodkin HP, Harper MB, Pomeroy SL. Intracerebral abscess in children: historical trends at Children's Hospital Boston. Pediatrics. 2004 Jun;113(6):1765-70. 摘要

Expert Panel on Neurologic Imaging; Whitehead MT, Cardenas AM, et al. ACR Appropriateness Criteria® headache. J Am Coll Radiol. 2019 Nov;16(11s):S364-77.全文  摘要

American College of Radiology. ACR-ASNR-SPR practice parameter for the performance and interpretation of magnetic resonance spectroscopy of the central nervous system. 2019 [internet publication].全文

Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. The rational use of antibiotics in the treatment of brain abscess. Br J Neurosurg. 2000 Dec;14(6):525-30. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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