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Fluorescence-guided surgery of brain abscesses.

Julius Höhne1, Alexander Brawanski1, Karl-Michael Schebesch1

  • 1Department of Neurosurgery, Medical Center of the University of Regensburg, Germany.

Clinical Neurology and Neurosurgery
|March 1, 2017
PubMed
Summary

Fluorescein Sodium (FL) effectively illuminated brain abscesses (BA) during surgery by highlighting areas with a disrupted blood brain barrier (BBB). This enhanced visualization aided in the complete surgical removal of abscesses without adverse events.

Keywords:
Brain abscessFluorescein sodiumFluorescence-guided surgeryYELLOW 560nm filter

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Area of Science:

  • Neurosurgery
  • Medical Imaging

Background:

  • Fluorescein Sodium (FL) is known to accumulate in brain areas with a disrupted blood-brain barrier (BBB).
  • Brain abscesses (BA) characteristically exhibit BBB disruption, suggesting FL's potential for intraoperative visualization.

Purpose of the Study:

  • To evaluate the efficacy of Fluorescein Sodium (FL) in enhancing intraoperative visualization of brain abscesses (BA).
  • To assess the utility of FL in combination with a surgical microscope's light filter for BA treatment.

Main Methods:

  • Seven patients with BA received 5mg/kg of FL intravenously before surgery.
  • Surgical reports were reviewed for observations on fluorescent staining intensity during procedures conducted under filtered light.

Main Results:

  • All patients demonstrated bright fluorescent staining of the affected brain areas.
  • Complete surgical removal of BA, including pus aspiration and capsule dissection, was achieved using fluorescence-guided techniques.
  • No adverse events were reported during the procedures.

Conclusions:

  • Fluorescein Sodium (FL) provided brilliant visualization of infected areas under a YELLOW 560nm filter, aiding neurosurgical procedures.
  • This study contributes to the growing use of FL in neurosurgery for non-neoplastic conditions.
  • Further prospective, randomized clinical trials are required to confirm the benefits of FL in treating brain abscesses.