[Brain abscess following thalamic hemorrhage: a case report]

Brain abscess following stroke is rare. We present a case of brain abscess which developed after hypertensive thalamic hemorrhage. A 51-year-old man had a left thalamic hemorrhage. Three months later, the patient was admitted to our hospital due to deterioration of right hemiparesis and motor aphasia. On admission, CT scan showed a ring-like high density area with peripheral edema in the left thalamus. T1-weighted magnetic resonance (MR) images revealed a large ring-enhanced lesion with surrounding edema in the same region. Laboratory examination demonstrated no signs of infectious disease. The patient's neurological state rapidly deteriorated 10 days after admission. Yellowish pus was aspirated during the emergent surgery. Bacteriological study of the pus revealed Staphylococcus Aureus. His symptoms improved after surgery followed by antibiotics therapy. The correct diagnosis prior to surgery was difficult in the present case because of lack of any signs of infection. Our case indicates that possibility of brain abscess should be taken into consideration as a rare differential diagnosis following intracerebral hemorrhage.