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A diagnostically challenging case of brain abscess with associated hemorrhage
Kenichiro Eza1, Gen Futamura1, Yoshihide Katayama2
1Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
Background:
Brain abscesses with associated hemorrhage are rare. Herein, we present a case of brain abscess with associated hemorrhage that posed a diagnostic challenge.
Case Description:
A 50-year-old male presented with the left homonymous hemianopia and was admitted to our hospital due to a subcortical hemorrhage in the right occipital lobe, which was revealed during a head magnetic resonance imaging (MRI). Subsequent imaging suggested an intra-tumoral hemorrhage, so surgical treatment was planned. However, on hospital day 6, the patient suddenly showed a decrease in consciousness level. Head MRI showed a high signal within the capsule on diffusion-weighted imaging, which spread to the ventricle and subarachnoid space. Brain abscess was suspected; therefore, an abscess drainage surgery was performed emergency. The postoperative course was relatively smooth.
Conclusion:
A brain abscess that perforates the ventricle has a poor prognosis, which emphasizes the need for early diagnosis and treatment. Although hemorrhage within a brain abscess is rare, it can complicate diagnosis, which, thus, underscores the importance of awareness.
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