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[Brain abscess following cerebral infarction: a case report].

K Ichimi1, H Ishiguri, Y Kida

  • 1Department of Neurosurgery, Komaki City Hospital, Japan.

No Shinkei Geka. Neurological Surgery
|April 1, 1989
PubMed
Summary

Brain abscesses can develop after cerebral infarction due to a weakened blood-brain barrier. Suspect brain abscess in stroke patients with fever or neurological changes.

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Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Cerebral infarction, a type of stroke, involves the blockage of blood supply to the brain.
  • Brain abscesses are pus-filled pockets within the brain tissue.

Observation:

  • A 73-year-old male presented with right hemiparesis and aphasia, diagnosed with left middle cerebral artery occlusion.
  • Following infarction, the patient developed seizures and persistent fever.
  • CT scans revealed multiple ring-enhancing cystic lesions at the infarction site, indicative of abscesses.

Findings:

  • Cultures from aspirated abscesses identified Proteus vulgaris.
  • A ventriculoperitoneal shunt was placed due to hydrocephalus.
  • Abscesses showed gradual resolution on follow-up CT scans.

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Implications:

  • Ischemic brain damage may compromise the blood-brain barrier and local immunity, facilitating abscess formation.
  • Transient bacteremia can lead to brain abscess in susceptible individuals.
  • Clinical suspicion for brain abscess is crucial in cerebral infarction patients presenting with fever, nuchal rigidity, or altered consciousness.