2007年5月
Delayed brain abscess after penetrating transorbital injury
NEUROLOGICAL SURGERY
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- ,
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- 巻
- 35
- 号
- 5
- 開始ページ
- 481
- 終了ページ
- 486
- 記述言語
- 日本語
- 掲載種別
- 研究論文(学術雑誌)
- 出版者・発行元
- IGAKU-SHOIN LTD
We report a case of brain abscess caused by a penetrating head injury that occurred 9 years earlier. A 14-year-old girl presenting with fever, headache, and stiff neck was admitted to our hospital. She was diagnosed with aseptic meningitis and treated conservatively. Seven days after admission she became stuporous and showed left hemiparesis. Computed tomography (CT) revealed two ring-enhancing masses with perifocal edema in the right frontal lobe. We diagnosed brain abscess and performed right Pronto-temporal decompressive craniectomy and stereotactic aspiration, followed by systemic antibiotic therapy. Post-surgery bone window CT revealed a well-defined, low-density foreign body passing from the left orbita to the right frontal lobe through the ethmoid sinus. We learned that the patient had been struck with a plastic chopstick in the left medial eyelid at the age of 5 years. No particular symptoms developed during the following 9 years. After the cerebral edema had diminished over the next 10 days, a second surgery was performed to remove the residual chopstick, repair the fistula at the base of the skull, and perform cranioplasty. The patient was discharged with only slight hyposmia after a 4-week course of antibiotics. This case showed that it is necessary to remove a residual foreign body and to close the dural fistula if there is a possibility of recurrent central nervous system infection. When a child presents with brain abscess, previous penetrating head injury should be considered.
- リンク情報
- ID情報
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- ISSN : 0301-2603
- PubMed ID : 17491344
- Web of Science ID : WOS:000246912400006