[CT-guided stereotactic operation for cerebellar abscess by the transtentorial hiatus approach: a case report]

We reported a case of cerebellar vermian abscess, well managed by CT-guided stereotactic aspiration and drainage via the transtentorial hiatus route. A 69-year-old man was admitted to our hospital because of acute deterioration of bronchiectasis. About one month later, he complained of headache and gait unsteadiness. CT scan revealed a multilocular abscess in the cerebellar vermis. Although conservative therapy with antibiotics was applied, the symptoms deteriorated and the lesion continued to grow. Aspiration and drainage were therefore performed for the main lesion by CT-guided stereotactic surgery via the transtentorial hiatus route. This was completed without complications. The postoperative course was good and the lesion had disappeared when enhanced CT was carried out about 2 months after the operation. We consider this stereotactic transtentorial hiatus operation to be an effective treatment for patients such as the present one with a superior vermian lesion and who is at risk due to a poor respiratory condition.