Symptoms of intracranial infection in children

Intracranial infection is a common brain lesion in children. This lesion can cause various brain diseases, such as encephalitis and meningitis. The pathogens of intracranial infection may be bacteria and viruses, as well as parasites, fungi, etc. Since it is a relatively serious infection, it must be treated promptly to prevent the condition from getting worse. Below, we will introduce you to the specific knowledge about intracranial infection in children.

The main intracranial infections include meningitis, encephalitis, brain abscess, etc. Pathogens may be bacteria, viruses, parasites, mycoplasma, chlamydia, fungi, rickettsia, etc. In some domestic studies, intracranial infection has been listed as one of the four major hospital infections (lung, urinary system, deep trauma incision, and intracranial). Pathogens mainly come from one's own flora, but can also come from the external environment, including surrounding patients or medical staff. Intracranial infections in the field of neurosurgery are mostly caused by trauma and surgery; hematogenous abscesses, parasitic diseases, granulomas, and tuberculosis are also common.

2. Diagnosis

1. Ask about the time of injury, the type of object that caused the injury, whether there is leakage of cerebrospinal fluid or brain tissue from the wound, and what treatment has been performed.

2. Examination of head wounds: Check the size and shape of the wound, whether there is active bleeding, bone fragments, brain tissue or cerebrospinal fluid outflow.

3. Impairment of consciousness: Patients with limited open injuries that do not damage important brain structures or do not have intracranial hypertension usually have no disturbance of consciousness; however, patients with extensive brain damage, brainstem or hypothalamic injuries, combined with intracranial hematoma or cerebral edema causing intracranial hypertension may have varying degrees of disturbance of consciousness.

5. Symptoms of intracranial hypertension: Patients with severe intracranial pressure increase caused by small wounds, hematoma within the wound, or (and) combined intracranial hematoma and extensive cerebral contusion and laceration may experience headache, vomiting, progressive disturbance of consciousness, and even brain herniation.

6. Skull X-ray to understand the location, type, displacement of skull fracture, location of metal foreign bodies or embedded objects in the skull, etc.

7. CT scan of the head can also diagnose intracranial hematoma, cerebral contusion, subarachnoid hemorrhage, midline shift, ventricular size and shape, intracranial foreign bodies and skull fractures, but it is not as complete as plain X-rays.

8. Lumbar puncture is helpful in understanding whether there is intracranial infection and intracranial pressure.

9. Electroencephalogram is helpful in diagnosing traumatic epilepsy.

In the past, conventional treatment for intracranial infectious diseases was to use large doses of parenteral antibiotics, but the treatment effect was often less than ideal due to the following factors:

(1) The existence of the blood-brain barrier prevents effective antibacterial concentrations from being reached in the cerebrospinal fluid;

(2) The pathogens of intracranial infection are resistant to most antibiotics;

(3) The infected cerebrospinal fluid lacks bactericidal activity and requires bactericidal rather than bacteriostatic drugs;

(4) The high cost of treatment often causes some patients to discontinue treatment. Intrathecal injection has gradually become popular in clinical practice due to its simple operation and proven efficacy.

Drugs and dosages that can be used for intrathecal injection (for reference only, to be supplemented)

Chemotherapy drugs such as dexamethasone, domestic amphotericin B, fluconazole, isoniazid, laxative, ceftriaxone, vancomycin, methotrexate, cytarabine and cyclocytidine