Related Experiment Videos
[Putaminal abscess occurring at the site of hemorrhage: a case report]
S Sumioka1, H Kajikawa, K Yamamura
1Section of Neurosurgery, Suiseikai Kajikawa Hospital.
Abstract:
Brain abscesses following stroke have been reported only rarely. We presented a case of putaminal abscess following putaminal hemorrhage. The patient was admitted to our hospital because of acute onset of left hemiplegia. The size of the hematoma was medium and the patient was conservatively treated. In about two months after the ictus, he became intermittently febrile and laboratory examinations suggested the presence of general infections including meningitis. Meanwhile, CT and MRI revealed clearly abscess formation at the site of the hematoma with remarkable brain edema. Cerebrospinal fluid analysis showed the findings of meningitis. On diagnosis of brain abscess, stereotactic exploration was performed and pus mixed with old blood was aspirated. Bacteriological study of the specimen demonstrated Morganella morganii. Postoperative course was uneventful and the abscess cavity gradually subsided following drainage and irrigation of the abscess cavity.
Insights
Brain abscesses are rare after stroke. This case details a putaminal abscess forming at a hemorrhage site, successfully treated with drainage and antibiotics.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Brain abscesses are uncommon complications following cerebrovascular events.
- Putaminal hemorrhage is a specific type of intracerebral hemorrhage.
- Early diagnosis and intervention are crucial for managing brain abscesses.
Observation:
- A patient presented with left hemiplegia due to a medium-sized putaminal hemorrhage, treated conservatively.
- Two months post-ictus, the patient developed fever and signs of infection, including meningitis.
- Imaging (CT and MRI) confirmed abscess formation at the hemorrhage site with significant brain edema.
Findings:
- Cerebrospinal fluid analysis indicated meningitis.
- Stereotactic aspiration revealed pus mixed with old blood.
- Bacteriological analysis identified Morganella morganii as the causative agent.
Implications:
- This case highlights a rare but serious complication of putaminal hemorrhage.
- Successful treatment involved stereotactic drainage, irrigation, and likely antibiotic therapy.
- Emphasizes the importance of considering infectious complications in stroke patients with delayed neurological deterioration.