[A case of solitary thalamic abscess treated by sterotactic aspiration]

The Solitary thalamic abscess appears to be uncommon, 17 cases have been reported since 1973. We successfully treated a case of thalamic abscess associated with diabetes mellitus by sterotactic aspiration with external drainage. A 55 years old man presented right hemiparesis. A computed tomographic (CT) scan revealed solitary thalamic low density lesion with ringed contrast enhancement. We started the administration of antibiotics, but on the 9th day he became drowsy and his eyes were deviated downward and inward. CT scan on the 10th day showed the edema had been spread to the tectum. We aspirated purulent fluid material with confidence by sterotactic operation. We considered the mid brain tectum to be responsible for the downward and medial deviation of the eyes, because it appeared only when the edema and abscess were spread to that area, and disappeared after aspiration of the abscess with subsidence of the edema.