scholarly journals Screening in cryptogenic brain abscess: Do not forget pulmonary arteriovenous malformations

2021 ◽  
Vol 12 ◽  
pp. 188
Author(s):  
Jasmien Rens ◽  
Thomas Van Thielen ◽  
Aurelie Derweduwen ◽  
Koen Goedseels ◽  
Robert Hes ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Left Lung ◽  
Occipital Lobe ◽  
Low Grade ◽  
Neurosurgical Procedures ◽  
Atrial Septum Defect ◽  
Source Of Infection ◽  
Contiguous Spread ◽  
Av Shunt ◽  
Dental Infections

Background: Brain abscess usually occurs secondary to trauma, through contiguous spread (e.g.; dental infections, [paranasal] sinusitis, otitis, and mastoiditis), after intracranial neurosurgical procedures, or through hematogenous spread in case of an arteriovenous (AV) shunt, for example; atrial septum defect. Although uncommon, another possible cause of AV shunt which can facilitate brain abscess is a pulmonary arteriovenous malformation (PAVM). We report a case of brain abscess secondary to a solitary PAVM and review the literature. Case Description: A 74-year-old male patient presented with headaches, fatigue, low-grade fever, and homonymous hemianopsia. He was diagnosed with a brain abscess in the left occipital lobe. A chest computed tomography (CT) with intravenous (IV) contrast was performed because of fever and respiratory insufficiency in a period where screening for COVID-19 in suspected patients was important. A solitary PAVM of the left lung was diagnosed. Initial stereotactic burr hole drainage of the abscess was insufficient and resection of the abscess was deemed necessary. Routine workup did not reveal any additional pathology apart from the PAVM. After treatment of the cerebral abscess, the PAVM was treated with embolization using an endovascular plug. Conclusion: It is recommended to screen for PAVM by chest CT with IV contrast in patients with brain abscess when no obvious source of infection can be identified.

What you need to know about brain abscesses

2020 ◽  
Vol 81 (8) ◽  
pp. 1-7
Author(s):  
Marta De Andres Crespo ◽  
Chris McKinnon ◽  
Jane Halliday
Keyword(s):  
Brain Abscess ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Morbidity And Mortality ◽  
Malignant Tumours ◽  
Brain Scans ◽  
Source Of Infection ◽  
Direct Inoculation ◽  
Conscious Level ◽  
Contiguous Spread

A brain abscess is a focal accumulation of pus in the brain parenchyma arising from direct inoculation, contiguous spread from local anatomical structures or haematogenous seeding from a remote source of infection. It can result in significant morbidity and mortality, making early diagnosis and treatment vital. Only one fifth of patients present with the classic triad of headache, fever and focal neurological symptoms. More commonly patients show signs and symptoms of raised intracranial pressure alone, such as confusion or reduced conscious level, headache, nausea and vomiting, which can be a presentation of many intracranial pathologies. Distinguishing an abscess from other pathologies such as meningitis and tumours is crucial, as clinically these can present in similar ways, but their management and outcomes are very different. Diffusion-weighted magnetic resonance imaging brain scans can help localise the lesion and differentiate ring-enhancing lesions caused by a brain abscess from malignant tumours. Cerebral abscesses are considered a neurosurgical emergency; early stabilisation, diagnosis and management in a neurosurgical centre is important in reducing morbidity and mortality.

scholarly journals Brain Abscess in the Current Decade (2010–2019) in India—A Review

2021 ◽  
Author(s):  
R. Ravikumar ◽  
Daisy Vanitha John
Keyword(s):  
Brain Abscess ◽  
Multidisciplinary Treatment ◽  
Treatment Strategies ◽  
Primary Source ◽  
Neurosurgical Procedures ◽  
Suppurative Otitis Media ◽  
Patients Âgés ◽  
Source Of Infection ◽  
Middle Ear Infection ◽  
Microbiological Techniques

AbstractBrain abscess outcomes have improved in recent years due to advancements in cranial imaging, microbiological techniques, minimally invasive neurosurgical procedures, and effective antibiotic treatments. However, the incidence of brain abscess remains unchanged in developing countries. We searched PubMed and Google Scholar for references using the key words “brain abscess” and “India” and reviewed both retrospective and prospective studies published in peer-reviewed journals in the current decade to understand the present status. The review shows that the patients’ ages, the predominance of male patients, the symptoms and locations of brain abscesses, and the types of bacteria associated with them have remained unchanged over the past decade. The most common predisposing condition in recent years has been chronic suppurative otitis media with a mortality rate of 7 to 10%. Middle ear infection is often neglected and not treated aggressively in Asian countries. It requires multidisciplinary treatment strategies to address the primary source of infection and better health awareness to prevent the development of brain abscess.

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

scholarly journals Ventriculitis: a severe complication of central nervous system infections

2021 ◽  
Author(s):  
David Luque-Paz ◽  
Matthieu Revest ◽  
François Eugène ◽  
Sarrah Boukthir ◽  
Loren Dejoies ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Behavior Disorder ◽  
Severe Complication ◽  
Limited Attention ◽  
Neurosurgical Procedures ◽  
Imaging Features ◽  
Neurological Sequelae ◽  
Single Centre Study ◽  
One Year ◽  
Gait Disturbances

Abstract Background Ventriculitis, a dreaded complication of brain abscess, meningitis, and various neurosurgical procedures, has attracted limited attention in the medical literature. Methods Retrospective single-centre study. We screened medical files of all patients who had a brain imaging report including the word “ventriculitis” during years 2005-2019. Only patients with clinical, microbiological and imaging features of ventriculitis were included. Data were collected through a standardized questionnaire. Results Ninety-eight patients fulfilled inclusion criteria: 42 women and 56 men, median age 60 years [interquartile range 48-68]. Primary mechanism for ventriculitis was classified as follows: brain abscess (n=29, 29.6%), meningitis (n=27, 27.6%), intraventricular catheter-related (n=17, 17.3%), post-neurosurgery (n=13, 13.3%), and hematogenous (n=12, 12.2%). Main neuroimaging features were intraventricular pus (n=81, 82.7%), ependymal enhancement (n=70, 71.4%) and intraventricular loculations (n=15, 15.3%). Main pathogens were streptococci (n=44, 44.9%), Gram-negative bacilli (n=27, 27.6%), and staphylococci (n=15, 15.3%). In-hospital and one-year mortality rates were, respectively, 30.6% (n=30), and 38.8% (n=38). Neurological sequelae were reported in 34/55 (61.8%) survivors, including cognitive impairment (n=11), gait disturbances (n=9), paresis (n=7), behavior disorder (n=6), epilepsy (n=5). On multivariate analysis, age > 65 years, Glasgow Coma Scale score < 13 at initial presentation, status epilepticus, hydrocephalus and positive cerebrospinal fluid culture were associated with one-year mortality. We built a scoring system to stratify patients with ventriculitis into low-risk (12.5%), intermediate-risk (36.5%), and high-risk (71.4%) of death. Conclusion Ventriculitis is a severe complication of brain abscess, meningitis, or neurosurgery, with in-hospital mortality rate of 30%, and neurological sequelae in 60% of survivors.

scholarly journals NIMG-19. USING FUNCTIONAL ULTRASOUND (FUS) TO MAP BRAIN FUNCTIONALITY AND TUMOR VASCULATURE WITH MICROMETER-MILLISECOND PRECISION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii151-ii151
Author(s):  
Sadaf Soloukey ◽  
Arnaud J P E Vincent ◽  
Djaina D Satoer ◽  
Frits Mastik ◽  
Marion Smits ◽  
...  
Keyword(s):  
Decision Making ◽  
High Resolution ◽  
Cerebral Blood Volume ◽  
Power Doppler ◽  
Awake Craniotomy ◽  
Frame Rate ◽  
Low Grade ◽  
Neurosurgical Procedures ◽  
Tumor Removal ◽  
Functional Areas

Abstract OBJECTIVE In the early 20th century, Dr. Cushing first demonstrated the use of electrical stimulation mapping (ESM) to define motor and sensory cortices during neurosurgical procedures. Essentially, little has changed in what guides a neurosurgeon’s intra-operative decision-making since. Inherent limitations of ESM such as limited depth penetration and risk of seizure elicitation, warrant the development of new image-guided resection tools. Here, we present functional Ultrasound (fUS)-imaging as a new, high-resolution tool to guide intra-operative decision-making during awake tumor removal. METHODS fUS relies on high-frame-rate ultrasound, which offers images at thousands of frames-per-second. As such, fUS is sensitive to very small motions caused by vascular dynamics (µDoppler), allowing measurements of changes in cerebral blood volume (CBV). This facilitates the possibility to 1) detect functional response, as CBV-changes reflect changes in metabolism of activated neurons through neurovascular coupling and 2) visualize high-resolution vascular morphology of tumor and healthy tissue. During conventional awake craniotomy surgery, n= 10 patients were asked to perform 60s functional tasks to elicit cortical responses. Simultaneously, a conventional 5 MHz ultrasound probe connected to an experimental acquisition system, was placed over ESM-defined functional areas. After image acquisition, correlation analyses with the corresponding tasks revealed functional and non-functional areas. In addition, 3D vascular maps were reconstructed from subsequent 2D-Power Doppler Images (PDIs). RESULTS fUS was able to detect functional areas as activated using conventional motor tasks, as well as complex language-related tasks. In addition, both 2D-PDIs and 3D-reconstructions revealed the ability of fUS to detect unique high-resolution onco-vascular characteristics in high- and low-grade malignancies. In all cases, images were acquired with micrometer-millisecond (300 µm, 1.5-2.0 msec) precision at imaging depths > 5 cm. CONCLUSIONS Applying fUS-imaging successfully in this awake craniotomy series serves as a clear demonstration of the technique’s revolutionary potential for maximizing safe tumor removal.

scholarly journals Genetic, cellular, and connectomic characterization of the brain regions commonly plagued by glioma

Brain ◽  
2020 ◽  
Vol 143 (11) ◽  
pp. 3294-3307
Author(s):  
Ayan S Mandal ◽  
Rafael Romero-Garcia ◽  
Michael G Hart ◽  
John Suckling
Keyword(s):  
Occipital Lobe ◽  
Brain Regions ◽  
Brain Dysfunction ◽  
Brain Atlas ◽  
Association Cortex ◽  
Low Grade ◽  
Expression Of Genes ◽  
Neuroimaging Data ◽  
Frequency Map ◽  
Multiple Graph

Abstract For decades, it has been known that gliomas follow a non-random spatial distribution, appearing more often in some brain regions (e.g. the insula) compared to others (e.g. the occipital lobe). A better understanding of the localization patterns of gliomas could provide clues to the origins of these types of tumours, and consequently inform treatment targets. Following hypotheses derived from prior research into neuropsychiatric disease and cancer, gliomas may be expected to localize to brain regions characterized by functional hubness, stem-like cells, and transcription of genetic drivers of gliomagenesis. We combined neuroimaging data from 335 adult patients with high- and low-grade glioma to form a replicable tumour frequency map. Using this map, we demonstrated that glioma frequency is elevated in association cortex and correlated with multiple graph-theoretical metrics of high functional connectedness. Brain regions populated with putative cells of origin for glioma, neural stem cells and oligodendrocyte precursor cells, exhibited a high glioma frequency. Leveraging a human brain atlas of post-mortem gene expression, we found that gliomas were localized to brain regions enriched with expression of genes associated with chromatin organization and synaptic signalling. A set of glioma proto-oncogenes was enriched among the transcriptomic correlates of glioma distribution. Finally, a regression model incorporating connectomic, cellular, and genetic factors explained 58% of the variance in glioma frequency. These results add to previous literature reporting the vulnerability of hub regions to neurological disease, as well as provide support for cancer stem cell theories of glioma. Our findings illustrate how factors of diverse scale, from genetic to connectomic, can independently influence the anatomic localization of brain dysfunction.

Brain Abscess

2016 ◽  
Author(s):  
Sneha A. Chinai
Keyword(s):  
Brain Abscess ◽  
Signs And Symptoms ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Source Of Infection ◽  
Empiric Antibiotic ◽  
Life Threatening ◽  
Brain Abscesses ◽  
The Brain ◽  
Repeat Imaging

A brain abscess is a life-threatening infection within the brain that originates as cerebritis and evolves into an encapsulated collection of purulent material. Epidemiologically, brain abscesses are seen more frequently in immunocompromised patients. The signs and symptoms of a brain abscess are influenced by the location and size of the infection, the causative pathogen, and the patient’s immune status and medical comorbidities. This diagnosis requires neurosurgical consultation for management and inpatient admission. The majority of patients undergo either needle aspiration or surgical excision. This is critical for obtaining a specimen for culture in order to direct accurate and specific antimicrobial therapy. Needle aspiration is more commonly utilized and has a lower mortality rate than surgical excision. Repeat imaging is required for any change in mental status. Empiric antibiotic selections are guided by the most likely source of infection and are adjusted for renal function.

scholarly journals Endobronchial low-grade MALT lymphoma causing unilateral hypertranslucency

2004 ◽  
Vol 61 (4) ◽  
Author(s):  
A.E. Erbaycu ◽  
I. Karasu ◽  
F.G. Özdemirkıran ◽  
N. Yücel ◽  
A. Özsöz ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Left Lung ◽  
Fiberoptic Bronchoscopy ◽  
Low Grade ◽  
Left Main ◽  
Bronchoscopic Biopsy ◽  
One Year ◽  
The Right

Mucosa-associated lymphoid tissue-derived lymphoma (MALT lymphoma) arises not only from the stomach but also from various non-gastrointestinal sites. A thirty two year old woman, suffering from breathlessness for one year, had been treated for bronchial asthma. A chest radiograph showed a mediastinum and heart transposition to the right side and emphysema of the left lung. In the thorax spiral tomography, a mass narrowing left main bronchi, five centimeters in length from the carina, was seen. A fiberoptic bronchoscopy revealed millimetric polypoid lesions those nearly totally obstructed the left main bronchi. The bronchoscopic biopsy showed a diagnosis of MALT lymphoma. She was seen for check-ups following chemotherapy but no further treatment has been carried out.

scholarly journals Rasmussen's Aneurysm Associate With Pulmonary Artery Vascular Malformation Presented With Haemoptysis

KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 168-170
Author(s):  
Khaleda Parvin Rekha ◽  
Umme Iffat Siddiqua ◽  
Md Mofazzal Sharif ◽  
Md Musharraf Husain ◽  
Mohammad Abdus Salam
Keyword(s):  
Pulmonary Artery ◽  
Ct Scan ◽  
Vascular Malformation ◽  
Left Lung ◽  
Lower Lobe ◽  
Low Grade ◽  
Imaging Department ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
Contrast Ct

Rasmussen's aneurysm is an inflammatory pseudo-aneurysmal dilatation of a branch of pulmonary artery associated with a cavitary lung lesion. Like any aneurysm, a Rasmussen's aneurysm is at increased risk of rupture and bleeding into the lungs. A 52 years old male presented with low-grade fever and haemoptysis, chest x-ray revealed a well margined nodular shadow with calcifications in mid zone of left lung associated with ipsilateral upper zone fibrosis and bronchiectasis. The patient had past history of pulmonary tuberculosis eight years back. For characterization of left pulmonary nodule the patient was referred to radiology and Imaging department and contrast CT scan of chest was done. Contrast CT scan of chest with reformat MIP pulmonary angiogram revealed a small pulmonary artery vascular malformation in lateral basal segment of lower lobe of left lung associated with left upper lobar cavitating lesion with fibrosis, traction bronchiectasis and Rasmussen's aneurysm arising from upper lobar apical segmental pulmonary artery. Early surgical or angiographic interventions with endovascular embolization are recommended once it be clearly diagnosed. KYAMC Journal Vol. 10, No.-3, October 2019, Page 168-170

Cryptospordiosis: An infectious emerging protozoan zoonosis of public health significance

2021 ◽  
Vol 6 (4) ◽  
pp. 161-163
Author(s):  
Mahendra Pal ◽  
Mati Roba Bulcha ◽  
Adugna Girma Lema ◽  
Sena Roba Bulcha
Keyword(s):  
Public Health ◽  
Point Of View ◽  
Watery Diarrhea ◽  
Low Grade ◽  
Economic Point ◽  
Source Of Infection ◽  
Animal Populations ◽  
Wide Range ◽  
The World ◽  
Hygienic Measures

Zoonoses caused by diverse etiological agents, are important from public health and economic point of view, and are reported in humans and animals from developing and developed nations of the world. Cryptosporidiosis is an emerging food and waterborne zoonotic protozoan disease that has been detected in both human and animal populations all over the world. The source of infection is exogenous, and the ingestion of contaminated food and water is the principal mode of transmission. The oocysts of Cryptosporidium are abundant and pervasive in ambient water, where they can survive for months. It prefers epithelial cells found in the digestive tracts of a wide range of hosts. Waterborne transmission through drinking water or a swimming pool is common, resulting in outbreaks in several nations throughout the world. The disease can manifest itself in sporadic or epidemic forms. The infection has been recorded in immunocompetent and immunocompromised individuals. The watery diarrhea, abdominal cramps, nausea, anorexia and low grade fever are most commonly observed symptoms. The laboratory help is required to make an unequivocal diagnosis of disease. The preventive strategies include excellent hygienic measures to avoid the contamination of food and water by oocysts of Cryptosporidium. In addition, the role of veterinarian is highly imperative for the management of disease in domestic animals.

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