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目的总结脑脓肿的临床特点,探讨其发病机制、影像学特点及与占位性病变的鉴别诊断。方法分析不典型隐源性脑脓肿1例,结合其发病特点、诊疗经过、辅检资料等,并复习文献。结果本例患者为67岁男性,突发起病,首发症状为右侧肢体活动障碍2 d,头颅CT示左侧顶叶低密度灶,入院后第3天出现畏寒、发热,伴恶心、呕吐,头颅MRI提示颅内占位,脑脓肿可能,最后经手术证实为脑脓肿。结论不典型脑脓肿的早期诊断常存在困难,了解脑脓肿不同病理分期及相对应的MRI、CT表现,结合病史,有助于与脑梗死、脑肿瘤相鉴别。
Objective To summarize the clinical features of brain abscess, explore its pathogenesis, imaging features and the differential diagnosis of lesions. Methods Atypical cryptogenic brain abscess was analyzed in 1 case, combined with the characteristics of its onset, diagnosis and treatment, auxiliary inspection data, and review of the literature. Results The patients were 67-year-old with sudden onset. The first symptom was the right limb movement disorder for 2 days. The cranial CT showed the left parietal lobe low density lesions. On the 3rd day after admission, chills, fever, nausea, Vomiting, cranial MRI prompted intracranial space, brain abscess may be confirmed by surgery for brain abscess. Conclusion There are many difficulties in the early diagnosis of atypical brain abscess. To understand the different pathological stages of brain abscess and the corresponding MRI and CT findings, combined with medical history, is helpful to distinguish with cerebral infarction and brain tumor.