[Delayed brain abscess after penetrating transorbital injury]
Tetsuya Hiraishi1, Masaru Tomikawa, Tsutomu Kobayashi
1Department of Neurosurgery, Nagaoka Red Cross Hospital, Nagaoka-city, Niigata, Japan.
No Shinkei Geka. Neurological Surgery
|May 12, 2007
Summary
A delayed brain abscess developed 9 years after a penetrating head injury from a plastic chopstick. Prompt surgical removal of the foreign body and fistula repair are crucial for preventing recurrent central nervous system infections.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Penetrating head injuries, even minor ones, can lead to delayed complications.
- Brain abscesses are serious infections requiring prompt diagnosis and treatment.
Observation:
- A 14-year-old girl presented with symptoms mimicking meningitis, later progressing to stupor and hemiparesis.
- Computed tomography (CT) revealed brain abscesses with a retained foreign body (plastic chopstick) identified 9 years after the initial injury.
Findings:
- Surgical intervention, including decompressive craniectomy, aspiration, foreign body removal, and fistula repair, was performed.
- The patient recovered after a course of antibiotics, with residual hyposmia.
Implications:
- This case highlights the importance of considering prior penetrating head trauma in pediatric brain abscess cases.
- Removal of retained foreign bodies and closure of dural fistulas are essential to prevent recurrent central nervous system infections.
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