Sporadic Use of Decompressive Hemicraniectomy in a Patient with Brain Abscess – a Case Report

Czech version

Authors: J. Mork ¹; D. Štěpánek ¹; V. Runt ¹; J. Hommerová ²; V. Přibáň ¹
Authors‘ workplace: LF UK a FN Plzeň, Neurochirurgické oddělení ¹; LF UK a FN Plzeň, Neurologická klinika ²
Published in: Cesk Slov Neurol N 2014; 77/110(6): 765-768
Category: Case Report

Podpořeno MZ ČR – RVO (Fakultní nemocnice Plzeň – FNPl, 00669806).

Overview

Brain abscess is caused by direct dissemination of inflammation from surrounding structures, remote infectious sources or is associated with brain trauma or neurosurgical procedures. Treatment includes surgical aspiration and intravenous antibiotics. Excision of the lesion is sometimes indicated. Antiedematous therapy is necessary in cases of brain oedema. At the present time, the majority of patients with brain abscesses survive and recover completely. Here we describe the case of a patient with brain abscess, whose condition deteriorated after aspiration of the lesion. The deterioration was due to progression of collateral brain oedema. After urgent decompressive craniectomy, the patient recovered completely. A cranioplasty was performed when the oedema disappeared. The abscess resolved completely following aspiration and antibiotic therapy. Fusobacterium and peptostreptococus were identified as the causative pathogens. Decompressive craniectomy has very rarely been applied in the treatment of brain abscesses and is reported sporadically.

Key words:
decompressive craniectomy – brain abscess – CNS infection

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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