Recurrent brain abscess induced by pulmonary arteriovenous fistula.
Brain abscess associated with an arteriovenous fistula (AVF) is sometimes difficult to diagnose and tends to recur. We report a case of recurrent brain abscess due to a pulmonary AVF (PAVF). A 69-year-old woman with a mass in the left cerebral peduncle had taken a progressively worse and shown decorticate rigidity. After an intravenous antibiotic for fever of unknown origin was changed, her condition gradually improved. She was discharged with the help of a cane. Thirty-one months later, she suffered left hemiparesis. Magnetic resonance imaging revealed a cystic mass in the right lateral frontal lobe. At surgery, we confirmed pus in the cyst. A PAVF was detected and was treated with coil embolization. The left hemiparesis improved and the postoperative course was uneventful. Exhaustive study is absolutely necessary to detect the etiology of recurrent brain abscess and to achieve a cure.
Department of Neurosurgery, Oyodo Town General Hospital, Oyodo, Nara, Japan. kaido@ncnp.go.jp
Takanobu
T
Kaido
Yoshio
Y
Moriyama
Katsuhiro
K
Ueda
Wataru
W
Higashiura
Hiroshi
H
Sakaguchi
Kimihiko
K
Kichikawa
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001164:Arteriovenous Fistula / Q000150:complications*; D001922:Brain Abscess / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*
D000900:Anti-Bacterial Agents