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Titolo:
Management of brain stem abscess
Autore:
Fuentes, S; Bouillot, P; Regis, J; Lena, G; Choux, M;
Indirizzi:
Dept Pediat Neurosurg, Marseille, France Dept Pediat Neurosurg MarseilleFrance iat Neurosurg, Marseille, France
Titolo Testata:
BRITISH JOURNAL OF NEUROSURGERY
fascicolo: 1, volume: 15, anno: 2001,
pagine: 57 - 62
SICI:
0268-8697(200102)15:1<57:MOBSA>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEDICAL THERAPY; MASS LESIONS; CURE; ASPIRATION; TOMOGRAPHY;
Keywords:
abscess; brain stem; stereotaxis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Fuentes, S Hop Timone, Serv Neurochirurg Professeur Francois Grisoli, 264 Blvd St Pierre, F-13385 Marseille 5, France Hop Timone 264 Blvd St Pierre Marseille France 5 lle 5, France
Citazione:
S. Fuentes et al., "Management of brain stem abscess", BR J NEUROS, 15(1), 2001, pp. 57-62

Abstract

The brain stem is an uncommon site of a brain abscess. Such lesions were invariably fatal before 1974, when the arrival of computed tomography and magnetic resonance imaging improved the prognosis. This new case with a good result shows the usefulness of early diagnosis, careful clinical and radiological monitoring and combined medical and surgical management. A child 2 1/2 years of age was admitted to the department of neurosurgery for diagnosis and treatment of a brain stem lesion. The clinical context and discovery of an intrabronchial foreign body, as well as neuroradiological investigations, suggested a diagnosis of brain stem abscess. Initial treatment with broad spectrum antibiotics with good cerebral penetration was associated withan increase in the size of the abscess and clinical worsening. Stereotactic aspiration of lesion was performed by a transpeduncular approach under CTguidance and general anaesthesia. Secondary thoracotomy enabled removal ofan intrabronchial needle. After evacuation, in spite of failure to identify the organism, neurological deficit resolved rapidly and the lesion no longer appeared on CT. Management of a brain abscess always includes antibiotics. They must cover the organisms most often encountered in brain abscessesand have good cerebral penetration. Medical treatment seems to suffice forsmall abscesses. A brain stem abscess with rapid clinical signs, together with current neuroradiogical diagnostic techniques, enables early discoveryof such abscesses when they are still small. Treatment of brain stem abscesses includes primary antibiotic therapy, then stereotaxic drainage when there is any diagnostic doubt, poor clinical tolerability or antibiotic resistance.

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Documento generato il 25/11/20 alle ore 03:26:51