INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generall...INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories： classic paraneoplastic limbic encephalitis （LE） associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens （e.g., Hu, Ma2, etc.） and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.展开更多
Background Intracranial infection is a common postoperative complication of neurosurgery. This study aimed to identify risk factors of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrh...Background Intracranial infection is a common postoperative complication of neurosurgery. This study aimed to identify risk factors of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrhea and to suggest proposals for the prevention. Methods A total of 167 patients （113 males and 54 males, average age of 34.4 years） with cerebrospinal fluid rhinorrhea operated on by the senior author were retrospectively reviewed. The data collected included etiology, previous history, clinical manifestation, site of bone defect, operative approach, and postoperative complications. Risk factor（s） for postoperative infection were analyzed using the stepwise multiple Logistic regression. Results Eighteen （10.8%） patients were infected post-operatively. The independent risk factors for infection were the site of defect （RR=0.508, 95% Cl 0.306-0.843, P=0.009） and historical meningitis （RR=0.290, 95% Cl 0.094-0.893, P=0.031）. Patients with multiple defects and saddle floor defects had a higher infection rate. The germiculture was positive in 11 patients, and vancomycin was sensitive to all the pathogenesis. Nine infected patients needed lumbar drainage. Ten patients had hyponatremia, and hydrocephalus occurred in two patients with serious trauma. Conclusions To prevent the infection, we should pay closer attention to the high-risk patients pre-operation. During the operation, the methods those can improve wound healing, such as using blood-supply materials, reliable fixation, and eliminating dead space are all helpful. Conducting lumbar drainage and choosing effective prophylactic antibiotics in the early postoperative stage for the high-risk patients are methods of postoperative management.展开更多
目的探讨新生儿化脓性脑膜炎的临床特点与早期诊断方法。方法选择2010年3月-2011年12月就诊于本院新生儿科疑似化脓性脑膜炎患儿100例,均于本院应用抗生素前行腰椎穿刺术,留取脑脊液(CSF)标本行常规、生化检测及培养,同时留取CSF 1 mL行...目的探讨新生儿化脓性脑膜炎的临床特点与早期诊断方法。方法选择2010年3月-2011年12月就诊于本院新生儿科疑似化脓性脑膜炎患儿100例,均于本院应用抗生素前行腰椎穿刺术,留取脑脊液(CSF)标本行常规、生化检测及培养,同时留取CSF 1 mL行PCR检测16 S rRNA。结果临床诊断为化脓性脑膜炎者40例,其中发热36例(90%),惊厥29例(72.5%),呼吸暂停5例(12.5%),前囟饱满23例(57.5%)。临床诊断为化脓性脑膜炎40例患儿,其CSF PCR检测均为阳性。CSF培养阳性5例,该5例CSF参数异常,PCR检测均呈阳性。PCR检测16 S rRNA阳性58例,PCR阳性率明显高于CSF培养、CSF参数(χ2=65.09,P=0.00;χ2=6.48,P=0.01)。结论新生儿化脓性脑膜炎临床特点不典型,CSF检查存在一定局限性,CSF培养阳性率低,结合PCR检测能提高阳性率。展开更多
文摘INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories： classic paraneoplastic limbic encephalitis （LE） associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens （e.g., Hu, Ma2, etc.） and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.
文摘Background Intracranial infection is a common postoperative complication of neurosurgery. This study aimed to identify risk factors of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrhea and to suggest proposals for the prevention. Methods A total of 167 patients （113 males and 54 males, average age of 34.4 years） with cerebrospinal fluid rhinorrhea operated on by the senior author were retrospectively reviewed. The data collected included etiology, previous history, clinical manifestation, site of bone defect, operative approach, and postoperative complications. Risk factor（s） for postoperative infection were analyzed using the stepwise multiple Logistic regression. Results Eighteen （10.8%） patients were infected post-operatively. The independent risk factors for infection were the site of defect （RR=0.508, 95% Cl 0.306-0.843, P=0.009） and historical meningitis （RR=0.290, 95% Cl 0.094-0.893, P=0.031）. Patients with multiple defects and saddle floor defects had a higher infection rate. The germiculture was positive in 11 patients, and vancomycin was sensitive to all the pathogenesis. Nine infected patients needed lumbar drainage. Ten patients had hyponatremia, and hydrocephalus occurred in two patients with serious trauma. Conclusions To prevent the infection, we should pay closer attention to the high-risk patients pre-operation. During the operation, the methods those can improve wound healing, such as using blood-supply materials, reliable fixation, and eliminating dead space are all helpful. Conducting lumbar drainage and choosing effective prophylactic antibiotics in the early postoperative stage for the high-risk patients are methods of postoperative management.
文摘目的探讨新生儿化脓性脑膜炎的临床特点与早期诊断方法。方法选择2010年3月-2011年12月就诊于本院新生儿科疑似化脓性脑膜炎患儿100例,均于本院应用抗生素前行腰椎穿刺术,留取脑脊液(CSF)标本行常规、生化检测及培养,同时留取CSF 1 mL行PCR检测16 S rRNA。结果临床诊断为化脓性脑膜炎者40例,其中发热36例(90%),惊厥29例(72.5%),呼吸暂停5例(12.5%),前囟饱满23例(57.5%)。临床诊断为化脓性脑膜炎40例患儿,其CSF PCR检测均为阳性。CSF培养阳性5例,该5例CSF参数异常,PCR检测均呈阳性。PCR检测16 S rRNA阳性58例,PCR阳性率明显高于CSF培养、CSF参数(χ2=65.09,P=0.00;χ2=6.48,P=0.01)。结论新生儿化脓性脑膜炎临床特点不典型,CSF检查存在一定局限性,CSF培养阳性率低,结合PCR检测能提高阳性率。
