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Pediatric brainstem abscess successfully treated with stereotactic aspiration: illustrative case
Nahom Teferi1, Ajmain Chowdhury2, Sarah Lee1
11Department of Neurosurgery, University of Iowa, Iowa City, Iowa.
Journal of Neurosurgery. Case Lessons
|August 15, 2023
Summary
Pediatric brainstem abscesses are rare neurosurgical emergencies. Prompt diagnosis and surgical aspiration are crucial for recovery, even with rapid neurological decline.
Area of Science:
- Pediatric Neurosurgery
- Infectious Disease
Background:
- Pediatric brainstem abscesses are rare, comprising 1% of all brain abscesses.
- These conditions represent a neurosurgical emergency requiring immediate attention.
Purpose of the Study:
- To highlight the diagnostic challenges and management of a pediatric brainstem abscess.
- To emphasize the importance of early recognition and intervention in cases of rapid neurological deterioration.
Main Methods:
- Case report of an 11-year-old male with a brainstem lesion.
- Diagnosis confirmed via MRI, showing lesion progression.
- Management involved emergent stereotactic aspiration and broad-spectrum antibiotics.
Main Results:
- Initial aspiration led to temporary improvement, followed by decline.
- A second stereotactic aspiration was required due to abscess regrowth.
- The patient achieved significant neurological recovery after rehabilitation.
Conclusions:
- A high index of suspicion is necessary for brainstem lesions mimicking tumors, especially with rapid decline.
- Stereotactic aspiration is vital for large abscesses to guide antibiotic therapy.
- Effective management combines surgical intervention with appropriate antibiotic treatment.
