Sudden "stroke-like' onset of homonymous hemianopsia due to bacterial brain abscess.
A previously healthy 40-year-old man experienced the sudden 'stroke-like' onset of homonymous hemianopsia due to a bacterial brain abscess. Clinical features and initial computed tomography (CT) suggested a stroke. Subsequent CT and magnetic resonance (MR) demonstrated a cerebral abscess, proven at surgery. It is extremely rare that a healthy individual without various risk factors, such as congenital heart disease, immunologic deficiency, diabetes mellitus, or pregnancy, presents with the above symptoms. The exact mechanism of this sudden 'stroke-like' onset in a patient with a bacterial brain abscess is unknown. One possibility is that paroxysmal septic emboli led to abscess formation within or near areas of embolic infarction. Another possibility is that a primary cerebral infarction was associated with secondary bacteremia. Surgical drainage revealed a bacterial (Streptococcus) abscess, but no identifiable source of infection.
Shintani
S
S
Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.
Tsuruoka
S
S
Koumo
Y
Y
Shiigai
T
T
D000328:Adult; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology; D001922:Brain Abscess / Q000000981:diagnostic imaging* / Q000382:microbiology; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000382:microbiology; D003937:Diagnosis, Differential; D006423:Hemianopsia / Q000000981:diagnostic imaging* / Q000382:microbiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed