Skip to main content
Log in

Brain stem abscesses in childhood

  • Case-based Update
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Solitary brain stem abscess is a rare condition with high mortality and morbidity. These lesions were considered to be invariably fatal before 1974 when advanced diagnostic tools were not available. Recently, the diagnosis and prognosis of brain stem abscesses have been modified by the introduction of modern radiological tools, and several patients with a favorable outcome have been reported since then. Because the pons is the most common site of the abscesses, involvement of the sixth and seventh nerves is frequent. The midbrain is the second most likely location, and medullary abscesses are distinctly rare. Treatment of a brain stem abscess includes medical therapy alone, open microsurgical intervention, or stereotactic aspiration.

Case report

We report a case of a 7-year-old girl with a solitary brain stem abscess. Her neurological examination revealed involvement of the cranial nerves and pyramidal tracts. Microsurgical exposure and aspiration of the abscess resulted in rapid improvement in her neurological condition and radiological resolution of the lesion. We discuss this uncommon case to draw attention to the importance of early diagnosis and adequate treatment, and we review the relevant literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Berg B, Franklin G, Cuneo R, Boldrey E, Strimling B (1978) Nonsurgical cure of brain abscess: early diagnosis and follow-up with computerized tomography. Ann Neurol 3:474–478

    CAS  PubMed  Google Scholar 

  2. Carpenter JL (1994) Brain stem abscesses: cure with medical therapy, case report and review. Clin Infect Dis 18:219–226

    CAS  PubMed  Google Scholar 

  3. Dake MD, McMurdo KS, Rosenblum ML, Brant-Zawadzki M (1986) Pyogenic abscess of the medulla oblongata. Neurosurgery 18:370–372

    CAS  PubMed  Google Scholar 

  4. Danziger J, Allen KL, Bloch S (1974) Brain-stem abscess in childhood. J Neurosurg 40:391–393

    CAS  PubMed  Google Scholar 

  5. Fuentes S, Bouillot P, Regis J, Lena G, Choux M (2001) Management of brain stem abscess. Br J Neurosurg 15:57–62

    Article  CAS  PubMed  Google Scholar 

  6. Fujino H, Kobayashi T, Goto I, Nagata E, Shima F (1990) Cure of a man with solitary abscess of the brain stem. J Neurol 237:265–266

    CAS  PubMed  Google Scholar 

  7. Fulgham JR, Wijdicks FM, Wright AJ (1996) Cure of a solitary brain stem abscess with antibiotic therapy: case report. Neurology 46:1451–1454

    CAS  PubMed  Google Scholar 

  8. Hulme A (1961) Suppurative lesions of the brainstem. J Neurol Neurosurg Psychiatry 24:291–293

    CAS  PubMed  Google Scholar 

  9. Imai H, Ono N, Zama A, Tamura M (1995) Diagnosis and treatment of brainstem abscess using magnetic resonance imaging and microsurgical aspiration. Neurol Med Chir 35:16–164

    Google Scholar 

  10. Jamjoom ZAB (1992) Solitary brainstem abscess successfully treated by microsurgical aspiration. Br J Neurosurg 6:249–254

    CAS  PubMed  Google Scholar 

  11. Kashiwagi S, Abiko S, Aoki H (1987) Brainstem abscess. Surg Neurol 28:63–66

    CAS  PubMed  Google Scholar 

  12. Messina AV, Guido LJ, Liebeskind AL (1977) Preoperative diagnosis of brain-stem abscess by computerized tomography with survival. J Neurosurg 47:106–108

    CAS  PubMed  Google Scholar 

  13. Miller ES, Dias PS, Uttley D (1988) CT scanning in the management of intracranial abscess: a review of 100 cases. Br J Neurosurg 2:439–446

    CAS  PubMed  Google Scholar 

  14. Nakajima H, Iwai Y, Yamanaka K, Kishi H (1999) Successful treatment of brainstem abscess with stereotactic aspiration. Surg Neurol 52:445–448

    CAS  PubMed  Google Scholar 

  15. Nauta HJW, Contreras FL, Weiner RL, Crofford MJ (1987) Brain stem abscess managed with computed tomography-guided stereotactic aspiration. Neurosurgery 20:476–480

    CAS  PubMed  Google Scholar 

  16. Rajshekhar V, Chandy MJ (1994) Successful stereotactic management of a large cardiogenic brain stem abscess. Neurosurgery 34:368–371

    CAS  PubMed  Google Scholar 

  17. Ruelle A, Zerbi D, Zuccarello M, Andrioli G (1991) Brain stem abscess treated successfully by medical therapy. Neurosurgery 28:742–746

    CAS  PubMed  Google Scholar 

  18. Russell JA, Shaw MDM (1977) Chronic abscess of the brain stem. J Neurol Neurosurg Psychiatry 40:625–629

    CAS  PubMed  Google Scholar 

  19. Sarma S, Sekhar LN (2001) Brain-stem abscess successfully treated by microsurgical drainage: a case report. Neurol Res 23:855–861

    CAS  PubMed  Google Scholar 

  20. VanGilder JC, Allen WE, Lesser RA (1974) Pontine abscess: survival following surgical drainage. J Neurosurg 440:386–390

    Google Scholar 

  21. Vaquero J, Cabezudo JM, Leunda G (1980) Nonsurgical resolution of a brain-stem abscess: case report. J Neurosurg 53:726–727

    CAS  PubMed  Google Scholar 

  22. Wang HS, Kuo MF, Huang SC (1992) Medical cure of a brainstem abscess and serial brainstem auditory evoked potentials. Dev Med Child Neurol 34:911–915

    CAS  PubMed  Google Scholar 

  23. Weickhardt GD, Davis RL (1964) Solitary abscess of the brainstem. Neurology 14:918–925

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Suzer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suzer, T., Coskun, E., Cirak, B. et al. Brain stem abscesses in childhood. Childs Nerv Syst 21, 27–31 (2005). https://doi.org/10.1007/s00381-004-1024-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-004-1024-1

Keywords

Navigation