Brain abscess following intracerebral hematoma
Kurihara, H.; Mitsui, T.; Kohno, N.
No Shinkei Geka. Neurological Surgery 17(11): 1037-1040
1989
ISSN/ISBN: 0301-2603 PMID: 2687710 Document Number: 329083
A 53-year-old man fully conscious was admitted with lt. hemiparesis due to a rt. putaminal hemorrhage. A phlebitis of superficial vein at lt. leg was noted on the 7th hospital day. Following administration of antibiotics, he was afebrile three days after. But local inflammation of phlebitis and leukocytosis continued for over one week. He had no sign of infection thereafter. Four months later, the hemiparesis exacerbated. CT scan revealed a cystic lesion with ring-like enhancement at the site of the hematoma. He was afebrile and had no sign of meningeal irritation. The patient underwent a stereotaxic aspiration of brown turbid pus. The culture from the aspirate was positive for staphylococcus, and histopathological examination of the excised specimen demonstrated a brain abscess with hemosiderin deposits. Follow-up CT scan revealed a progressive diminution in the size of the abs cess. We felt the hematoma represented an area of locus minoris resistentiae and that bacterial seeding of the hematoma from phlebitis resulted in brain abscess formation. Brain abscess formation should be considered as having possibly developed in patients with clinical deterioration after cerebral vascular disease.