Chronic brain abscess secondary to a retained wooden foreign body: diagnostic and management dilemmas.
A four-year-old child presented with recent onset generalized tonic clonic seizures. She was operated for a suspected intracranial tuberculoma and was found to harbor an intra-parenchymal retained wooden foreign body with a chronic abscess. The foreign body had entered the brain parenchyma after a minor head injury, sustained three years earlier. She was asymptomatic for the intervening three years. The initial diagnosis was missed by several physicians. A retained wooden fragment via a transtemporal apparently closed head injury is an extremely rare event. The present study reveals the diagnostic and therapeutic challenges and stresses the importance of high degree of suspicion to diagnose retained intracranial foreign bodies and the need for early surgical exploration, to avoid chronic and potentially life threatening neurological complications.
Dadlani
Ravi
R
Department of Neurosurgery, Sri Satya Sai Institute of Higher Medical Sciences, Bangalore, India. dr_ravi@doctor.com
Ghosal
Nandita
N
Bagdi
Naman
N
Venkatesh
Prasanna K
PK
Hegde
Alangar Sathya
AS
D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014934:Wood
BMJ. 1998 May 2;316(7141):1363-4
9563992
Acta Neurochir (Wien). 1967;16(3):201-17
6075110
Neurol Med Chir (Tokyo). 2000 Sep;40(9):458-62
11021077
Ophthalmic Plast Reconstr Surg. 1990;6(2):108-14
2285659
J Clin Neurosci. 1997 Apr;4(2):255-7
18638966
Acta Neurochir (Wien). 2004 Aug;146(8):847-50
15254807
Surg Neurol. 1977 Feb;7(2):95-103
835079
Neurosurg Focus. 2008;24(6):E8
18518753
AJNR Am J Neuroradiol. 2005 Aug;26(7):1855-7
16091543
Surv Ophthalmol. 1992 Mar-Apr;36(5):341-4
1566235
J Neurosurg. 1988 May;68(5):752-6
3357035