Successful microsurgical resection of a large brainstem abscess: case report and literature review

Dzhindzhikhadze RS, Dreval ON, Lazarev VA, et al. . Successful microsurgical resection of a large brainstem abscess: case report and literature review. Burdenko's Journal of Neurosurgery. 2022;86(3):56‑62. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20228603156

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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Abstract:

OBJECTIVE

To present a patient with brainstem abscess treated by microsurgical resection.

CASE PRESENTATION

A 53-years-old female patient admitted to the neurosurgical department in a severe condition with symptoms of intracranial hypertension, hyperthermia, general infectious signs and laboratory manifestations of infectious process. Contrast-enhanced MRI revealed a large brainstem lesion (abscess). Retrosigmoid craniotomy with total microsurgical resection of the abscess was performed. External ventricular drainage was incerted on the second postoperative day due to progressive hydrocephalus with clinical deterioration, it was removed in 8 days. Slow positive dynamics was observed in postoperative period. The patient was discharged in 2 weeks after surgery.

CONCLUSION

There are no established algorithm for the treatment of brainstem abscesses. Therapeutic approach is advisable for small abscesses. There are 2 neurosurgical options for this lesion: stereotactic drainage and microsurgical resection with or without external ventricular drainage. Treatment strategy depends on location and size of abscess, as well as clinical state of the patient.

Keywords:

brainstem abscess

brainstem microneurosurgery

retrosigmoid craniomy

Authors:

Dzhindzhikhadze R.S.

Vladimirsky Moscow Regional Research Clinical Institute;
Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0003-3283-9524

Dreval O.N.

Russian Medical Academy of Continuing Professional Education

ORCID: 0000-0002-8944-9837

Lazarev V.A.

Russian Medical Academy of Continuing Professional Education

ORCID: 0000-0001-9663-0960

Polyakov A.V.

Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0000-0001-7413-1968

Kambiev R.L.

Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0000-0003-3694-4698

Fedorov D.N.

Moscow regional research clinical institute n.a. M.F. Vladimirskiy

Banina V.B.

Vladimirsky Moscow Regional Research Clinical Institute

Barbashova A.S.

Stupino Regional Clinical Hospital

Antoshin Yu.M.

Stupino Regional Clinical Hospital

Received:

27.10.2020

Accepted:

25.03.2022

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References:

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