| Autor: |
Korfias, Stefanos, Themistoklis, Konstantinos, Vlachakis, Eustathios, Komaitis, Spyridon, Giakoumettis, Dimitrios, Boviatsis, Konstantinos, Themistocleous, Marios, Sakas, Damianos |
| Zdroj: |
Stereotactic & Functional Neurosurgery; 2016 Supplement 1, Vol. 94, p80-80, 1/2p |
| Abstrakt: |
Objectives: Presentation of an unusual case of a late intracranial infection in a patient with history of epilepsy surgery. Methods: A 48 year old female patient with medicallyresistant extratemporal epilepsy underwent two stages operation in 2012. In stage I, she underwent a left fronto-temporal craniotomy and subdural electrodes were placed over the left frontotemporal cortical area. Following a week of intracranial recordings she underwent, stage II operation with left frontal multiple subpial transection (Morrell operation) and anterior 1/3 corpus callosotomy. She had an uneventful post-operative course and the epileptic activity was successfully controlled with anticonvulsive therapy. Recently, she presented with a swelling of her left frontal scalp, pyrexia (38.5 °C), generalized weakness and memory deficits. Her brain CT scan revealed an epidural collection. Results: She underwent surgical exploration in the operating theater. Skin necrosis adjacent to her old skin incision was noted. Following debridement of the necrotic areas a purulent subcutaneous collection was found and evacuated. The bone flap of the old craniotomy was removed and osteomyelitic foci were identified. The epidural space had an abundant collection of pus that was also evacuated. After meticulous irrigation and debridement, the dura matter remained intact. The bone flap was discarded and the skin sutured properly. Staphylococus hominis was cultivated from the wound. Antibiotic therapy with vancomycin and metronidazole was commenced, according to sensitivities. Post-operatively, the patient had 2 seizures that were successfully controlled with anticonvulsants. She remained afebrile after the 2nd week. Conclusions: Skin erosion along old skin surgical incision and epidural empyema formation could be an uncommon late complication, following consecutive epilepsy operations. In our case, surgical debridement with empyema evacuation, craniectomy and antibiotic therapy, secured patient full recovery. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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