CNS Infection

CNS InfectionDody Priambada SMF Bedah Saraf Kariadi/FK Undip

www.dodypriambada-bedahsaraf.blogspot.comCNS InfectionMeningitisEncephalitisVentriculitisBrain: Cerebral AbscessTB (Tuberculoma)Paracyte : Toxoplasma gondii, Cysticercosis, roundworm Trichinella spiralis, Rubella, Mumps, Rabies, AIDSMedulla Spinalis : Arachnoiditis, Poliomyelitis, Spondilitis TB (corpus vertebra)

www.dodypriambada-bedahsaraf.blogspot.comMeningitisUmumnya disertai encephalitisViral, TB (terbanyak), Infeksi kuman non spesifik Streptococcus, Haemophlus Influenzae tipe B, Neisseria Meningitidis Klinis : demam, penurunan kesadaran, kaku kuduk Komplikasi : Hydrocephalus communicans ec perlengketan arachnoid -> arachnoid space tertutupLab: LP -> *analisa LCS * Darah : lekositosis

www.dodypriambada-bedahsaraf.blogspot.comMeningitisPre contrastPost Contrast: vascular and basal arachnoid hiperdensitywww.dodypriambada-bedahsaraf.blogspot.com

Cerebral AbscessSoliter or multipleSoliter: Direct spreading dari :Inf Sinus Fr/eth or teeth -> frontalInf Sinus max -> temporalInf Sin sphenoid -> fr/tempInf mastoid -> abses di cerebelum /tempCerebral Abscess -Multiple :Remote Spreading/Hematogen : Penyakit Jantung Kongestif (TF), ASD-> bacteria not filtered from their blood in the pulmonary capilary bedwww.dodypriambada-bedahsaraf.blogspot.comCerebral AbcessEarly Cerebritis : day 1-3Late Cerebritis: day 4-9Early Capsul Form: day 10-13Late Capsul Form: day> 14www.dodypriambada-bedahsaraf.blogspot.comCerebral Abscess Encapsulated stadium in contrast scan

Early n soliterLate n multipleCerebral AbscesTeraphy:- Steroid -> decrease perifocal edema but decrease efficacy antibioticAntibiotic 4-6 wksSurgery : more than 2.5 cm easy reached location non eloquent area

Tuberculoma : TB on the BrainMycobacterium TBTB Pulmo or Lymphe (aktive/non activeHiperdens but no enhance contrast because : necrotic caseosaClinical Finding: General : raised ICP Local : depend on locationLab : ICT TB/Mantoux, LED Tuberculoma

www.dodypriambada-bedahsaraf.blogspot.comNecrosis caseosaSpondilitis TB : TB on spineDirect spreading from Pulmo TB commonly on Thorax levelDeficit neurologis as levelX ray : Cold Abscess n destruction of vertebral bodyMRI : more detail spinal cord compression Cold Abscess / Paravertebral Ascess(X Ray)

Spondilitis TB (MRI)

Spondilitis TB (MRI)