scholarly journals Brain abscess: Current management

2013 ◽  
Vol 04 (S 01) ◽  
pp. S67-S81 ◽  
Author(s):  
Hernando Alvis Miranda ◽  
Sandra Milena Castellar Leones ◽  
Mohammed Awad Elzain ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Clinical Outcomes ◽  
Brain Abscess ◽  
Clinical Presentation ◽  
Epidural Abscess ◽  
Brain Parenchyma ◽  
Surgical Skills ◽  
Current Management ◽  
Brain Infection ◽  
Focal Infection ◽  
The Brain

ABSTRACTBrain abscess (BA) is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well?vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA.

Brain Abscess and Spinal Epidural Abscess

2019 ◽  
pp. 642-648
Author(s):  
Selby G. Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Abscess ◽  
Hospital Admissions ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Early Management ◽  
Brain Abscesses ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural ◽  
The Brain

Two infections of the brain are relatively common. Patients with brain abscess are often critically ill and have a high mortality rate. The reported incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000 people. In contrast, spinal epidural abscess (SEA), an infection of the epidural space, has increased in incidence from approximately 0.2 to 1.2 per 10,000 hospital admissions in the mid-1970s to a currently estimated 2.0 to 12.5 per 10,000 admissions. Both disorders are now more easily detected with magnetic resonance imaging (MRI), and this has improved early management, but clinical recognition is still a challenge for many physicians.

Reevaluation of an experimental streptococcal canine brain abscess model

1987 ◽  
Vol 67 (5) ◽  
pp. 717-720 ◽  
Author(s):  
Henry Kurzydlowski ◽  
Cynthia Wollenschlager ◽  
Frank R. Venezio ◽  
Mona Ghobrial ◽  
Morris Marc Soriano ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Brain Parenchyma ◽  
Antimicrobial Treatment ◽  
Histopathological Study ◽  
Bacterial Inoculation ◽  
Content Type ◽  
Treatment Regimens ◽  
The Brain ◽  
Fine Print

✓ An experimental cerebral abscess model in which alpha-hemolytic Streptococci were inoculated into the brain parenchyma of dogs was evaluated for assessment of antimicrobial therapy. Intracerebral ring-enhancing lesions were visualized by computerized tomography, but they resolved after time without therapeutic intervention. Histopathological study demonstrated evolution of the lesions into sterile granulomas. Quantitative cultures were performed and uniformly became sterile in the early cerebritis stage, approximately 3 days after bacterial inoculation. Therefore, this brain abscess model should not be utilized for the evaluation of new antimicrobial treatment regimens. Rather, other models which document persistent viable organisms within cerebral abscesses need to be developed.

scholarly journals Prevotella brain abscess in a healthy patient with a patent foramen ovale: Case report

2021 ◽  
Vol 12 ◽  
pp. 548
Author(s):  
Yu Akimoto ◽  
Kiyoyuki Yanaka ◽  
Kuniyuki Onuma ◽  
Kazuhiro Nakamura ◽  
Eiichi Ishikawa
Keyword(s):  
Brain Abscess ◽  
Patent Foramen Ovale ◽  
Foramen Ovale ◽  
Brain Infection ◽  
Source Of Infection ◽  
Venous Shunt ◽  
Life Threatening ◽  
Brain Abscesses ◽  
The Right ◽  
The Brain

Background: Brain abscesses are relatively rare life-threatening infectious lesions often concomitant with a direct spillover of inflammation in the head or neck, hematogenous infections, and immunocompromised conditions. They rarely occur in adults without such predisposing factors. Prevotella is a well-known dental pathogen that very rarely causes brain abscesses. Case Description: We report such an abscess in a 51-year-old man who was innately healthy and had no oral lesions. A comprehensive computed tomography examination of the chest, abdomen, and pelvis, was inconclusive but a transesophageal echocardiogram bubble study revealed a mild patent foramen ovale (PFO) that matched Grade 1 criteria. We deduced that the right-left shunt due to the PFO could have contributed to the brain infection and treated the patient successfully via surgical abscess aspiration and antibiotics. Conclusion: In case of a brain abscess occurring in healthy adults, it is essential to investigate the source of infection and the existence of an arterio-venous shunt, such as PFO.

Supratentorial Arachnoid Cyst Located in the Brain Parenchyma: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (1) ◽  
pp. E258-E262 ◽  
Author(s):  
Kyung-Jae. Park ◽  
Shin-Hyuk. Kang ◽  
Yang-Seok. Chae ◽  
Yong-Gu. Chung
Keyword(s):  
Frontal Lobe ◽  
Arachnoid Cyst ◽  
Clinical Presentation ◽  
Brain Parenchyma ◽  
Cystic Mass ◽  
Clear Fluid ◽  
Computed Tomographic ◽  
History Of ◽  
The Right ◽  
The Brain

abstract BACKGROUND AND IMPORTANCE: Arachnoid cysts have not been reported to be located within the brain parenchyma. We present a case of an arachnoid cyst that was contained entirely within the right frontal lobe devoid of communication with the subarachnoid space and ventricle. CLINICAL PRESENTATION: A 65-year-old woman presented with a 1-year history of progressive headache and nausea. Computed tomographic and magnetic resonance imagining scans showed a well-defined, nonenhancing mass measuring 5 × 5 × 3.5 cm in the right frontal lobe. The mass appeared to be contained entirely within the brain parenchyma. The patient underwent a right frontal craniotomy, at which time the cystic mass was identified in the brain parenchyma without any communication with the arachnoid space. The cyst contained a clear fluid, and its wall was excised. The fluid contents demonstrated a composition similar to that of normal cerebrospinal fluid. Histological and immunohistochemical examinations of the cyst wall were compatible with the diagnosis of an arachnoid cyst. Postoperatively, the symptoms of the patient resolved, and no recurrence was observed up to 6 months after removal. CONCLUSION: The present case showed an intraparenchymal arachnoid cyst arising in the frontal lobe. Although the etiology is not known, an arachnoid cyst should be included in the differential diagnosis of primary intracerebral cysts.

scholarly journals Brain Abscess Associated with Polymicrobial Infection after Intraoral Laceration: A Pediatric Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fumihiro Ochi ◽  
Hisamichi Tauchi ◽  
Toyohisa Miyata ◽  
Tomozo Moritani ◽  
Toshiyuki Chisaka ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Fusobacterium Nucleatum ◽  
Brain Parenchyma ◽  
Pediatric Case ◽  
Parvimonas Micra ◽  
Increased Risk ◽  
Brain Abscesses ◽  
Congenital Cyanotic Heart Disease ◽  
The Brain

Brain abscesses, infections within the brain parenchyma, can arise as complications of various conditions including infections, trauma, and surgery. However, brain abscesses due to polymicrobial organisms have rarely been reported in children. We herein report a case of a 9-year-old girl with unresolved congenital cyanotic heart disease (CCHD) presenting with right hemiplegia who was diagnosed with brain abscess caused by Streptococcus intermedius, Parvimonas micra, and Fusobacterium nucleatum after oropharyngeal injury. She was treated with intravenous antimicrobial therapy, drainage under craniotomy, and antiedema therapy with glycerol and goreisan, which led to the improvement of right hemiplegia to baseline; she was discharged following eight weeks of intravenous antimicrobial therapy. The clinical diagnosis of the brain abscess was difficult due to the nonspecific presentation, highlighting the importance of cranial imaging without haste in patients at increased risk for brain abscesses such as those with CCHD, presenting with fever in the absence of localizing symptoms or fever, accompanied with abnormal neurological findings.

Medullary abscess: a rare clinical presentation

2020 ◽  
Vol 13 (3) ◽  
pp. e233286
Author(s):  
Pavels Muranovs ◽  
Claire Gillon ◽  
John Norris
Keyword(s):  
Clinical Presentation ◽  
Rapid Onset ◽  
Brain Parenchyma ◽  
Causative Organism ◽  
Dental Infection ◽  
Medical Practitioners ◽  
Brain Abscesses ◽  
The Brain ◽  
Prompt Diagnosis ◽  
Early Surgical Intervention

Brain abscesses represent areas of localised infection of the brain parenchyma. Those confined to the brainstem are rare and usually fatal if untreated. Streptococcus intermedius is a common causative organism of brain abscesses and is associated with significant morbidity. We describe a case report of medullary abscess secondary to dental infection in a 68-year-old patient. The patient presented with headaches and flu-like symptoms progressing to left hemiparesis and reduced consciousness/bulbar function. The patient underwent emergency posterior fossa craniectomy and drainage with subsequent medical management with antibiotics. Prompt diagnosis, early surgical intervention and maximal therapy with antibiotics alongside extensive rehabilitation are all vital to ensure good neurological outcome. It is imperative for medical practitioners to consider the diagnosis of brain abscess in patients presenting with rapid onset neurological deterioration. Such cases require early neurological imaging with involvement of tertiary neurosurgery services.

scholarly journals Cysticercal Brain Abscess: A Distinct Entity Mimicking Pyogenic Brain Abscess.

2021 ◽  
Author(s):  
Radhika Mhatre ◽  
Subhas Konar ◽  
Nishanth S. ◽  
Anita Mahadevan ◽  
B. Indira Devi
Keyword(s):  
Brain Abscess ◽  
Clinical Presentation ◽  
Surgical Excision ◽  
Histopathological Diagnosis ◽  
Rare Entity ◽  
Radiological Findings ◽  
Distinct Entity ◽  
Solitary Lesion ◽  
Short Course ◽  
The Brain

Abstract Cysticercal brain abscess is a rare entity with the clinical presentation and radiological findings closely mimicking a pyogenic abscess. We report three cases of cysticercal abscess presenting as solitary lesion in the brain with radiological appearance like an abscess. All the patients underwent excision of the lesion with histopathological diagnosis of cysticercal brain abscess. The clinical outcome was satisfactory after surgical excision. Cysticercal abscess, though rare, should be considered as a differential diagnosis of a solitary rim-enhancing lesion, mainly if the patients belong to the endemic zone of neurocysticercosis. Surgical excision with or without a short course of the anti-parasitic agent is the treatment of choice.

298 Neurosarcoidosis – review of 91 patients from three UK neuroscience centres

2018 ◽  
Vol 89 (10) ◽  
pp. A47.3-A47
Author(s):  
Farwana Reem ◽  
Murley Alex ◽  
Ankrah Lauren ◽  
Whittam Dan ◽  
Hayton Tom ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Pulmonary Sarcoidosis ◽  
Brain Parenchyma ◽  
Limb Weakness ◽  
Pooled Data ◽  
Retrospective Audit ◽  
Clinical Presentations ◽  
Radiological Changes ◽  
The Brain ◽  
Over 40 Years

BackgroundNeurosarcoidosis is a rare neuro-inflammatory disease with a wide variety of clinical presentations.MethodsRetrospective audit was conducted independently at Birmingham, Liverpool and Nottingham to identify patients with neurosarcoidosis and pooled data was analysed.Results88% of the 91 patients identified presented over 40 years of age. From the data available, 70% were White Caucasians, 21% Afro-Caribbeans and 8% were Asians. Optic neuritis (31%), limb weakness (30%), headaches (20%) and facial palsy (19%) were the most common clinical presentations with nearly a third of patients (27/91) having moderate or severe disability (modified Rankin scale ≥3) at onset. 27/58 (46.6%) of patients had raised serum ACE levels and 37/44 (84%) patients had raised CSF protein with 28/41 (68.3%) demonstrating CSF lymphocytosis (mean – 54, range 5 to 380 cells). 35/91 patients had radiological changes affecting the brain parenchyma with 23% showing leptomeningeal enhancement. 75% of the 36 patients with data available for CT chest showed evidence of pulmonary sarcoidosis. Steroids were administered in 84.9% (73/86) patients with 21 receiving steroid sparing drugs, mainly Azathioprine and Mycophenolate.ConclusionWe discuss the varied clinical presentation of neurosarcoidosis across three major UK neuroscience centres and attempt to risk stratify patients prior to immunomodulatory therapy.

scholarly journals Group G Streptococci in association with brain abscess: a rare occurrence

2014 ◽  
Vol 8 (11) ◽  
pp. 1488-1490
Author(s):  
Parimala Subramani ◽  
Vidhya Raja ◽  
Bipinchandra Bhagath Lingaiah ◽  
Beena Prasavangada Madappa ◽  
Hariprakash Chakravarthy
Keyword(s):  
Brain Abscess ◽  
Congenital Anomalies ◽  
Rare Case ◽  
Female Child ◽  
Brain Parenchyma ◽  
Neurological Symptoms ◽  
Rare Occurrence ◽  
Group G Streptococci ◽  
Life Threatening ◽  
The Brain

Brain abscess is a serious life-threatening infection of the brain parenchyma. We are reporting a rare case of brain abscess caused by Group G Streptococcus in a 12 year-old female child who presented with neurological symptoms. She was diagnosed with congenital anomalies of the heart at birth. She was treated with amoxyclav and ciprofloxacin. The child recovered and was discharged uneventfully.

scholarly journals Mechanisms of Neurodegeneration in Various Forms of Parkinsonism—Similarities and Differences

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 656
Author(s):  
Dariusz Koziorowski ◽  
Monika Figura ◽  
Łukasz M. Milanowski ◽  
Stanisław Szlufik ◽  
Piotr Alster ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Tau Protein ◽  
Protein Gene ◽  
Clinical Presentation ◽  
Neuronal Loss ◽  
Corticobasal Degeneration ◽  
Inflammatory Factors ◽  
Parkinsonian Disorders ◽  
Genetic Features ◽  
The Brain

Parkinson's disease (PD), dementia with Lewy body (DLB), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy (MSA) belong to a group of neurodegenerative diseases called parkinsonian syndromes. They share several clinical, neuropathological and genetic features. Neurodegenerative diseases are characterized by the progressive dysfunction of specific populations of neurons, determining clinical presentation. Neuronal loss is associated with extra- and intracellular accumulation of misfolded proteins. The parkinsonian diseases affect distinct areas of the brain. PD and MSA belong to a group of synucleinopathies that are characterized by the presence of fibrillary aggregates of α-synuclein protein in the cytoplasm of selected populations of neurons and glial cells. PSP is a tauopathy associated with the pathological aggregation of the microtubule associated tau protein. Although PD is common in the world's aging population and has been extensively studied, the exact mechanisms of the neurodegeneration are still not fully understood. Growing evidence indicates that parkinsonian disorders to some extent share a genetic background, with two key components identified so far: the microtubule associated tau protein gene (MAPT) and the α-synuclein gene (SNCA). The main pathways of parkinsonian neurodegeneration described in the literature are the protein and mitochondrial pathways. The factors that lead to neurodegeneration are primarily environmental toxins, inflammatory factors, oxidative stress and traumatic brain injury.

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