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Neuroradiology

, Volume 44, Issue 5, pp 438–442 | Cite as

Dynamic changes during evacuation of a left temporal abscess in open MRI: technical case report

  • R. Bernays
  • S. Kollias
  • Y. Yonekawa
Interventional Neuroradiology

Abstract

We demonstrate the usefulness of "near real-time" neuro-navigation by open MRI systems for guidance of stereotactic evacuation of intracranial abscesses. A 70-year-old patient was referred to our institution with an intracranial left temporal abscess. He presented with headache, senso-motor aphasia and mild right hemiparesis. The abscess (35×25 mm) was stereotactically evacuated under MRI guidance, and a recurrence of a daughter abscess was again evacuated on the 9th postoperative day. "Near real-time" imaging showed an indentation of the abscess wall of 11 mm along the trajectory. A thermosensitive MRI protocol demonstrated a higher temperature around the abscess capsule than in the brain tissue more distant to the capsule, demonstrating the inflammatory process. The patient had 6 weeks of antibiotic therapy for gram-negative bacteria and was discharged with improved clinical symptoms 5 weeks after admission. Follow-up CT 2 months postoperatively showed a complete resolution of the abscess. Open MRI-guided interventions with "near real-time" imaging demonstrate the anatomical changes during an ongoing procedure and can be accommodated for enhancing the overall precision of stereotactic procedures. Thermosensitive MRI protocols are capable of revealing temperature gradients around inflammatory processes.

Intracerebral abscess Intra-operative MRI Stereotaxy 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • R. Bernays
    • 1
  • S. Kollias
    • 2
  • Y. Yonekawa
    • 1
  1. 1.Department of Neurosurgery, University Hospital, Frauenklinikstrasse 10, 8091 ZurichSwitzerland
  2. 2.Institute of Neuroradiology, University Hospital of Zurich, ZurichSwitzerland

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