Brain Abscess, Associated with Intracerebral Hematoma in a Child: Report of One Case.

Kim, Soon Kie; Moon, Myong Sun

Original Article

Journal of Korean Neurosurgical Society 1984;13(3): 483-489.

Department of Neurosurgery, Seoul Red Cress Hospital, Seoul, Korea.

ABSTRACT

We report a rare case of brain abscess associated with intracerebral hematoma in a child at the age of 3. A 3 years old female child has been suffered from the cellulites with pustule on her right leg since 3 weeks before, which has aggravated gradually, and developed acute bacterial meningitis for 2 weeks before transfer to Department of Neurosurgery. The acute bacterial meningitis has been treated for 2 weeks in Pediatric Department. The brain CT revealed a small brain abscesses in the occipital region bilaterally. With methicillin, the clinical progress including C.S.F. findings has got improvement, which has been almost complete. We found the staphylococcus from the pustule on her right leg by smear and culture. At that time, 3 weeks since the onset, suddenly vomiting, consciousness change(drowsy to semicomatose), left hemiparesis developed. Immediate brain CT revealed multiple abscess in both occipital poles with bulky intracerrebral hematoma in right perietooccipital region. Immediate craniectomy was performed for removal of intracranial hematoma, which was ca 50cc in amount, at first, and bilateral trephination with aspiration and drainage for the multiple brain abscess at second. The postoperative course was satisfactory with mannitolization and antibiotic treatment. The recovery was dramatic one.

Key Words: Celluitis with pustule; Multiple brain abscess; Intracerebral hematoma; Staphylococcus; Craniectomy; Aspiration and drainage