[A case presenting brain abscess with multiple infectious aneurysms].
We report a case presenting a brain abscess with multiple infectious aneurysms. A 59-year-old man was transferred to our hospital suffering from left hemiparesis. MRI demonstrated a huge mass in the right frontal lobe with marked brain edema in the surrounding area. Diffusion-weighted image revealed heterogenous intensity, which is not typical in cases of brain abscess. Surgical removal was planned, and preoperative angiography was performed. Angiography demonstrated aneurysms at the distal branch of both the right middle cerebral artery and the anterior cerebral artery. These aneurysms were surgically resected, and the abscess was totally removed. Postoperative course was uneventful. Left hemiparasis was resolved, and there was no ischemic lesion seen on postoperative MRI. In the treatment of brain abscess, stereotactic aspiration has recently been preferred to removal by craniotomy. We conclude that cerebral angiography might be necessary to evaluate cerebrovascular complications including infectious aneurysms, in cases presenting atypical findings in neuroimaging study.
Murakami
Kensuke
K
Department of Neurosurgery, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori-city, Aomori 030-8553, Japan.
Takahashi
Noboru
N
Matumura
Nobuhisa
N
Umezawa
Kunihiko
K
Midorikawa
Hiroshi
H
Kaimori
Mitsuomi
M
Nishijima
Michiharu
M
D000368:Aged; D000785:Aneurysm, Infected / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001922:Brain Abscess / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D014057:Tomography, X-Ray Computed