Clinical Case Study of a Surgically Treated Patient for Multiple Brain Abscesses

Abstract

With a higher incidence in developing countries, mainly affecting males, in a ratio of 3: 1 (men: women), brain abscesses are purulent collections encapsulated or not encapsulated in the brain parenchyma, which may have as a source, the hematogenous pathway, by contiguity or by direct trauma. Risk factors are lung abscesses, arterio-venous fistulas, immunodeficiency, chronic sinusitis / otitis or dental procedures. Most patients with bacterial brain abscess require surgical treatment for optimal therapy. The two available procedures are aspiration of the abscess after the placement of the burr holes or complete excision after craniotomy. A clinical case study was performed on a 22-year-old patient, hospitalized and treated surgically for multiple brain abscesses, in the Neurosurgery Clinic of the County Emergency Hospital, Constanta. The patient is known with chronic maxillo-ethmoido-sphenoidal sinusitis with multiple hospitalizations on the ORL department, for surgical evacuation of purulent secretions, transferring to our clinic after highlighting an interhemispheric subdural empyema and right parieto-occipital brain abscess, visible on MRI contrasting of brain. Surgery is performed, by right temporo-parietal craniotomy and evacuation of the purulent collection, the post-operative evolution being clinically and imagistically favorable, after adjuvant antibiotic therapy with Meronem, Vancomycin and Metronidazole.

Keywords

• abcess
• abcess surgery
• inflammatory samples