1/897. brain abscess caused by streptococcus intermedius: two case reports.BACKGROUND: Although streptococcus intermedius has been recognized as an important pathogen for abscess formation outside the central nervous system, the streptococcus milleri group, of which it is a member, has not been recognized as a specific pathogen for brain abscess, often thought to be caused by Streptococcus viridans, which includes other streptococcal species. CASE DESCRIPTION: Two cases of brain abscess in the left frontal lobe caused by S. intermedius, which responded well to antimicrobial treatment combined with needle aspiration, are presented. In the first patient, the predisposing disease was paranasal sinusitis of the frontal and ethmoid sinuses. In the second patient, the source of the pathogen was not detected despite extensive examination. The patients underwent aspiration of pus under ultrasound guidance in the first patient, and via a computed tomography-guided stereotactic procedure in the second patient. They subsequently received appropriate antimicrobial therapy against S. intermedius isolated from the pus culture. Both patients were discharged without any neurological deficits. CONCLUSION: It is important to recognize S. intermedius as a pathogen of brain abscess, and to be aware of its predisposing factors, i.e., mucosal disturbance and liver abscess.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/897. Identification of the cause of a brain abscess by direct 16S ribosomal dna sequencing.We report the case of a young man who apparently suffered successive episodes of meningitis and cerebral abscess over a 1-month period, both of which were diagnosed by two different molecular approaches; PCR for neisseria meningitidis IS1106 from CSF and 16S rRNA gene sequencing on a specimen of brain pus. In each case, cultures were negative due to prior antibiotic therapy.- - - - - - - - - - ranking = 1.7919037883245keywords = brain, cerebral (Clic here for more details about this article) |
3/897. A surgical method for treating anterior skull base injuries.skull base surgery was performed on 18 patients with anterior skull base injuries. The operative technique consisted of opening the operative field in the anterior skull base via a coronal incision and a frontal craniotomy, debridement of the anterior skull base including the injured dura mater, performing drainage from the anterior skull base to the nasal cavity by ethmoidectomy, and reconstructing the resulting dural and anterior skull base defect using bilateral temporal musculo-pericranial flaps and a bone graft. Seventeen of the 18 patients recovered without any complications, although epidural abscesses in the anterior skull base had been present in four patients at the time of the operation. Only one patient developed an epidural abscess in the anterior skull base after the operation. None of the patients developed any other complications including meningitis, recurrent liquorrhoea or cerebral herniation. Satisfactory aesthetic results were achieved in 16 of the 18 patients. In one patient, uneven deformity of the forehead, which was caused by the partial sequestration of the frontal bone due to postoperative infection, was observed. In another patient, a depressed deformity of the forehead, which was caused by the partial loss of the frontalis muscle following the use of the frontal musculo-pericranial flap instead of a temporal musculo-pericranial flap, was observed. Anterior skull base reconstruction using bilateral temporal musculo-pericranial flaps provides excellent results in terms of patient recovery and aesthetics.- - - - - - - - - - ranking = 0.12523712165781keywords = cerebral (Clic here for more details about this article) |
4/897. actinomycosis of the central nervous system: surgical treatment of three cases.Three cases of actinomycotic brain infection are described, 2 of which manifested as cerebral abscess, the third as epidural empyema. Complete resolution of the infection was always achieved by means of surgical treatment and prolonged antibiotic therapy. The cases reported emphasize the importance of a combined approach in the treatment of this unusual cause of brain infection.- - - - - - - - - - ranking = 0.79190378832448keywords = brain, cerebral (Clic here for more details about this article) |
5/897. role of stereotactic aspiration in the management of tuberculous brain abscess.BACKGROUND: Intracranial tuberculous abscesses are uncommon clinical entities, even in countries where tuberculosis is endemic. Surgical excision and antituberculous treatment is the treatment of choice. The role of stereotactic aspiration in the management of these lesions is highlighted in this communication. methods: Three patients, all receiving treatment for pulmonary tuberculosis, presented with symptoms of raised intracranial pressure and neurological deficits. Computed tomography (CT) scans revealed cystic lesions with enhancing rim in the thalamus in two patients and multiple coalescing cystic lesions in the deep temporal region in another. RESULTS: Stereotactic aspiration of the cyst and biopsy of the cyst wall were performed in all. In two, the pus revealed acid fast bacilli (AFB). In another, though the pus did not reveal any AFB, the wall showed tuberculous granuloma. Antituberculous treatment was continued in all the patients. Follow-up CT revealed resolution of the lesions in all patients. CONCLUSION: Stereotactic aspiration is an useful alternative modality of management of tuberculous abscesses in a selected group of patients.- - - - - - - - - - ranking = 1.3333333333333keywords = brain (Clic here for more details about this article) |
6/897. Palinopsia with bacterial brain abscess and noonan syndrome.Though positive visual symptoms can be psychological in nature, or can result from a perceptive or anxious patients recognizing optical principals in the eye itself, this case illustrates how a thorough history is required to delineate those rarer signs which accompany serious macular or neuro-ophthalmic pathology.- - - - - - - - - - ranking = 1.3333333333333keywords = brain (Clic here for more details about this article) |
7/897. brain abscess caused by salmonella enteritidis in an immunocompetent adult patient: successful treatment with cefotaxime and ciprofloxacin.A previously healthy 43-y-old man, who had spent 2 weeks in northern india, was admitted to hospital after a 2-day history of pyrexia, confusion and frontal headache. Cranial computerized tomography (CT) showed an abscess in the right parietal lobe. Spinal fluid and blood cultures gave growth of salmonella enteritidis within 24 h. Treatment with cefotaxime was initiated, but ceased after 3 weeks due to drug fever, and ciprofloxacin was then given orally for 4 months. After 6 months, the patient was considered cured. Cases of salmonella brain abscesses are reviewed.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
8/897. Postcraniotomy gas-containing brain abscess: a neurosurgical emergency. Case report.BACKGROUND: Gas-containing brain abscesses are very rare, and the majority are caused by clostridium perfringens. We report a case of gas-containing brain abscess that required urgent surgery after a craniotomy for a brain tumor. methods AND RESULTS: The patient was a 53-year-old male who presented with a cerebral neoplasm. A temporal lobectomy was performed and the diagnosis of low grade glioma was confirmed. Although the surgery was uneventful the postoperative course was complicated; the patient became agitated and febrile and deteriorated to a deep coma. A computed tomography scan demonstrated gas in the temporal fossa at the lobectomy site, producing mass effect. Urgent surgical debridement and drainage was performed and C. perfringens and mixed flora were found. Antibiotics were started and the patient's condition markedly improved. He was awake and alert, followed commands adequately and was extubated; however, after a week he suffered massive gastrointestinal bleeding and died. CONCLUSIONS: Early recognition of a gas-containing brain abscess is of great interest to immediately start the appropriate treatment. Urgent surgical debridement and broad spectrum chemotherapy are major components in the management of this entity.- - - - - - - - - - ranking = 2.7919037883245keywords = brain, cerebral (Clic here for more details about this article) |
9/897. Delayed intracranial abscess after acoustic neuroma surgery: a report of two cases.OBJECTIVE: The use of antibiotics before and after surgery has made infectious complications of neurotologic surgery rare. The neurosurgical literature cites a rate of postoperative meningitis between 1% and 2% for "clean" cases and 1.5% to 2.5% for "clean contaminated" cases, such as cerebrospinal fluid contact with the middle ear or mastoid. Reports of infections after neurotologic procedures are rare in the otologic literature. In this report, two patients with brain abscess occurring in a delayed fashion after surgery are described. STUDY DESIGN: The study design was a retrospective chart review and case report. SETTING: The study was conducted at a tertiary referral center. RESULTS: Patient 1 underwent a suboccipital craniotomy for removal of an acoustic neuroma and had an uneventful postoperative recovery. Three months after surgery, he reported mild unsteadiness. Examination revealed mild ataxia, which led to repeat magnetic resonance imaging (MRI) and a diagnosis of cerebellar abscess. Patient 2 underwent translabyrinthine removal of an acoustic neuroma complicated by postoperative pseudomonas aeruginosa meningitis, which responded promptly to intravenous antibiotics. Fifteen months after surgery, he visited a neurologist after having a seizure and was treated with anticonvulsants. After a second episode of seizure, imaging studies showed a temporal lobe abscess. CONCLUSIONS: The signs of intracranial abscess may be subtle and can occur weeks or months after surgery, requiring vigilance and a high index of suspicion for diagnosis. A change in postoperative symptoms after acoustic neuroma surgery should signal further investigation using MRI with gadolinium.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
10/897. brain abscess caused by cladosporium trichoides (Bantianum): a case with paranasal sinus involvement.Dematiacious fungi (ie, fungi with dark hyphae) are a rare and usually fatal cause of central nervous system infection. cladosporium trichoides has been implicated most frequently. documentation of extra-CNS involvement has been rare. Our patient had a brain abscess and paranasal sinus infection due to C trichoides. The organism was sensitive to less than or equal 2mug/ml of flucytosine. Although our patient did not receive flucytosine, it is possible that this drug, because of its excellent penetration into the cerebrospinal fluid, may be a useful therapeutic agent in cerebral cladosporiosis.- - - - - - - - - - ranking = 0.45857045499115keywords = brain, cerebral (Clic here for more details about this article) |
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