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Diagnostic and management of pediatric brain stem abscess, a case-based update

Houssine Ghannane1, Mehdi Laghmari, Khalid Aniba

  • 1Department of Neurosurgery, UHC Mohammed VI, Faculty of Medicine, Cadi Ayyad University, Marrakesh, Morocco.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|June 1, 2011
PubMed

Insights

Pediatric brain stem abscesses are rare but require high clinical suspicion for optimal outcomes. Microsurgical or stereotactic aspiration are effective treatments, leading to good recovery in pediatric cases.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Pediatric brain stem abscesses are uncommon neurological emergencies.
  • Early diagnosis is often delayed despite significant neurological deficits.

Observation:

  • A 2.5-year-old girl with a delayed diagnosis of brain stem abscess presented with hemiparesis, cranial nerve palsies, and respiratory issues.
  • Magnetic resonance imaging confirmed a pontine abscess, necessitating microsurgical aspiration.
  • The patient achieved full neurological recovery post-surgery with lesion regression over four months.

Findings:

  • The mean age for pediatric brain stem abscess is 8.1 years, with no gender predilection.
  • Common symptoms include increased intracranial pressure, motor deficits, and cranial nerve palsies.
  • While mortality has decreased since the 1980s, significant morbidity, particularly affecting motor function, persists.

Implications:

  • A high index of clinical suspicion is crucial for improving functional outcomes in pediatric brain stem abscess.
  • Stereotactic-guided or microsurgical aspiration remain viable and effective therapeutic strategies.
  • This case highlights the importance of timely diagnosis and management of rare pediatric central nervous system infections.
Abstract

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