ΥΠΟΣΚΛΗΡΙΔΙΑ ΕΜΠΥΗΜΑΤΑ ΤΟΥ ΕΓΚΕΦΑΛΟΥ: ΜΕΛΕΤΗ 32 ΠΕΡΙΠΤΩΣΕΩΝ.

Abstract

Η ΠΑΡΟΥΣΑ ΕΡΓΑΣΙΑ ΕΒΑΣΙΣΘΗ ΕΠΙ 32 ΠΕΡΙΠΤΩΣΕΩΝ ΑΣΘΕΝΩΝ ΜΕ ΥΠΟΣΚΛΗΡΙΔΙΑ ΕΜΠΥΗΜΑΤΑ, ΚΕΙΜΕΝΑ ΥΠΕΡΘΕΝ ΤΟΥ ΣΚΗΝΙΔΙΟΥ ΤΗΣ ΠΑΡΕΓΚΕΦΑΛΙΔΟΣ (SUPRATENTORIAL). ΟΙ ΑΣΘΕΝΕΙΣ ΟΥΤΟΙ ΕΝΟΣΗΛΕΥΘΗΣΑΝ ΕΙΣ ΤΟ REGIONAL CENTRE FOR NEUROSURGERY DERBYSHIRE ROYAL INFIRMARY, DERBY, ENGLAND ΚΑΙ ΕΙΣ ΤΟ REGIONAL CENTRE FOR NEUROSURGERY, OLDCHURCH HOSPITAL, ROMFORD, ENGLAND, ΚΑΤΑ ΤΑ ΕΤΗ 1957 - 1969. ΟΙ ΠΛΕΙΣΤΟΙ ΤΩΝ ΑΣΘΕΝΩΝ ΔΙΕΚΟΜΙΣΘΗΣΑΝ ΕΙΣ ΤΑ ΝΕΥΡΟΧΕΙΡΟΥΡΓΙΚΑ ΚΕΝΤΡΑ ΕΞ ΕΤΕΡΩΝ ΝΟΣΟΚΟΜΕΙΩΝ ΟΠΟΥ ΗΔΙΑΓΝΩΣΙΣ ΕΙΧΕΝ ΥΠΟΨΙΑΣΘΗ ΤΗΝ ΥΠΑΡΞΙΝ ΤΟΥ ΕΜΠΥΗΜΑΤΟΣ. ΑΙ ΠΕΡΙΓΡΑΦΟΜΕΝΑΙ ΔΙΑΓΝΩΣΤΙΚΑΙ ΚΑΙ ΘΕΡΑΠΕΥΤΙΚΑΙ ΜΕΘΟΔΟΙ ΕΙΝΑΙ ΩΣ ΑΥΤΑΙ ΕΦΗΡΜΟΣΘΗΣΑΝ ΚΑΙ ΕΞΕΙΛΙΧΘΗΣΑΝ ΕΙΣ ΤΑ ΕΝ ΛΟΓΩ ΚΕΝΤΡΑ. (ΠΕΡΙΓΡΑΦΗ ΠΕΡΙΛΗΨΗΣ)

THIRTY TWO CASES OF SUBDURAL ABSCESS SEEN BETWEEN 1957 AND 1969 AT THE REGIONAL NEUROSURGICAL UNITS AT OLDCHURCH HOSPITAL, ROMFORD AND THE DERBYSHIRE ROYALINFIRMARY, DERBY, ARE ANALYZED. AGE AND SEX DISTRIBUTION IS GIVEN IN TABLE 1.IT WILL BE OBSERVED THAT MALES OUTNUMBER THE FEMALES AT THE RATIO OF 3:1. MORE THAN HALF OF THE CASES ARE IN THE 10 - 30 AGE GROUP. THE INCIDENCE OF SUBDURAL ABSCESS IN MALES IS SIGNIFICANT AND MUST BE RELATED TO THE INCREASED INCIDENCE OF E.N.T. SEPSIS IN MALES. THE PRIMARY SITE OF INFECTION IS SET OUT IN TABLE 2. IN TWO - THIRDS OF THE CASES SEPSIS ORIGINATED IN THE PROVINCE OF THE EAR, NOSE AND THROAT SURGEON IN THE PARANASAL AIR SINUSES OR THE MIDDLE EAR. THE PRESENTING SYMPTOMS AND SIGNS ARE GIVEN IN TABLE 3. FEVER WAS INVARIABLE, RANGING FROM 100 F. TO 102.6 F. HEADACHE, VOMITING AND PAPILLOEDEMA, THE CLASSICAL TRIAD OF RAISED INTRACRANIAL PRESSURE, WAS OFTEN SEEN. HEMIPARESIS, ASSOCIATED WITH DYSPHASIA WHEN THE DOMINANT HEMISPHERE WAS AFFECTED, WAS A MORE COMMON FEATURE. EPILEPTIC ATTACKS OCCURED IN ONE HALF OF THE CASES. ACCORDING TOTHE CONSCIOUS LEVEL, THE THIRTY TWO CASES WERE DIVIDED AS FOLLOWS: ALERT 5 DROWSY 21 COMATOSE 6. INVESTIGATIONS. THE SKULL X-RAY WAS AVAILABLE FOR EXAMINATION IN 16 CASES. IN 13 THERE WAS OPACITY OF ONE OR MORE OF THE PARANASAL AIR SINUSES. THE SUTURES WERE WIDENED IN TWO CASES (ABSTRACT TRUNCATED)