Unusual complications and presentations of intracranial abscess: experience of a single institution.
BACKGROUND
Complicating events and unusual presentations associated with intracranial abscess are rare but potentially fatal conditions. This study was undertaken to shed light on the unusual complications and presentations of intracranial abscess treated at a single institution.


METHODS
We retrospectively reviewed 116 cases of intracranial abscesses that were treated at our institution over the last 10 years and identified 11 (9.4%) cases with unusual complications.


RESULTS
These complications consisted of (1) rupture within the abscess, (2) hemorrhage into the abscess, (3) hemispheric infarction due to ICA thrombosis, (4) acute visual loss due to pituitary abscess, (5) acute neurologic deterioration due to rapid gas formation within the abscess, (6) acute hydrocephalus, (7) trigeminal neuralgia, (8) fungal abscess developing secondary to intracranial extension of a temporal bone tumor, (9) Cryptococcus abscess with different morphology, (10) pontine infarction, and (11) sigmoid sinus thrombosis. Sinusitis accompanied 8 (72.7%) of the cases, and there were 5 (45.4%) mortalities. Culture results were unyielding in 4 patients, whereas Streptococcus species were identified in 4 and fungi in the rest.


CONCLUSIONS
Intracranial abscesses and their complications still continue to be challenging entities in the neurosurgical practice. Our experience may provide an informational source for those who are taking care of patients with intracranial abscess.
Kocaeli
Hasan
H
Department of Neurosurgery, Uludağ University School of Medicine, Gorukle Campus, Bursa 16059, Turkey. hkocaeli@uludag.edu.tr
Hakyemez
Bahattin
B
Bekar
Ahmet
A
Yilmazlar
Selçuk
S
Abas
Faruk
F
Yilmaz
Emel
E
Korfali
Ender
E
D000293:Adolescent; D000328:Adult; D001922:Brain Abscess / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D020314:Central Nervous System Fungal Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000209:etiology; D002544:Cerebral Infarction / Q000209:etiology; D015331:Cohort Studies; D003244:Consciousness Disorders / Q000209:etiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014277:Trigeminal Neuralgia / Q000209:etiology