Brain abscess complicating hemorrhagic contusion in a case of closed head injury: Case report

Abstract

Brain contusions commonly are identified in patients with traumatic brain injury (TBI) and represent regions of primary neuronal and vascular injury. These edematous lesions contain punctate parenchymal hemorrhages, which are termed micro-hemorrhages. These hemorrhages rarely get infected by hematogenous spread of microorganisms causing a brain abscess. Delayed brain abscess formation in the contusion is a very rare entity. We report a one year old patient who had traumatic right parietal hemorrhagic contusion with no external wound. She was managed conservatively. Two weeks after injury he deteriorated in neurological status and was found to have developed brain abscess. Patient underwent immediate craniotomy with drainage of abscess and excision of abscess wall; she was discharged home after one week. Infective complication can occur rarely even after closed head injury and should be kept as a differential diagnosis in a patient with delayed deterioration.

Keywords

• brain abscess
• hemorrhagic contusion