Gunshot craniocerebral wound complicated by anaerobic brain abscess. Case report and literature review

Brain abscess is a focal infectious inflammatory lesion characterized by collection of pus in brain tissue surrounded by a vascularized capsule. The most common cause is spread of microorganisms from distant foci of infection (e.g., odontogenic infection or sinusitis). The risk of intracranial infectious complications and mortality increases significantly in penetrating gunshot wounds to the skull and brain.

MATERIAL AND METHODS

Available literature contains a few studies on infectious complications following combat traumatic brain injury. This article presents treatment of anaerobic brain abscess in a patient with previous penetrating gunshot skull wound.

RESULTS

A 24-year-old patient admitted for specialized medical care with penetrating blind radial shrapnel skull and brain wound in the left occipital region complicated by intracerebral anaerobic abscess. The patient underwent secondary surgical debridement of craniocerebral wound, removal of abscess, and drainage system placement. On the fourth postoperative day, sedation was discontinued. There was moderate impairment of consciousness. By the ninth day, consciousness became normal. After primary treatment, the patient was transferred for rehabilitation.

CONCLUSION

This case highlights the role of strict adherence to the principles of emergency neurosurgical care when treating wounds complicated by intracranial infection.