Cerebellar bacterial brain abscess: report of eight cases.
OBJECTIVE
To analyze the clinical characteristics and therapeutic outcome of patients with solely cerebellar bacterial brain abscess (BBA).


METHODS
Eight patients with solely cerebellar BBA, collected during a period of 23 years from 210 BBA patients, were included in this study. The eight patients were five men and three women, aged 5-54 years (mean, 36.6 years). Six of them were adults, one was a child, and one was an adolescent. Six patients had underlying medical/surgical problems. Of the clinical presentations, dizziness was the most common (87.5%, 7/8), followed by headache (62.5%, 5/8), altered consciousness (62.5%, 5/8), fever (50%, 4/8), ataxia (25%, 2/8), hearing impairment (12.5%, 1/8), dysarthria (12.5%, 1/8), and hemiparesis (12.5%, 1/8). The Image Severity Index (ISI) scores of these eight patients ranged from 6 to 12 points. All eight patients received both medical and surgical treatment. One patient died owing to a complication in the neurosurgical procedure and the remaining patients survived. The therapeutic outcome was quantified one month after discharge by modified Rankin scale (mRS) and the result showed six of the seven survivors had good outcomes, while the other one had a poor outcome (ataxic gait).


CONCLUSIONS
Cerebellar BBA accounted for 3.8% (8/210) of the overall BBA. In cerebellar BBA, dizziness is a frequent symptom. Early diagnosis and a combination of antimicrobial and neurosurgical intervention is important for its treatment. The small case number is a limitation of this study; therefore, further large-scale study of cerebellar BBA is needed for better delineation of the clinical characteristics, therapeutic outcome, and prognostic factors.
Department of Neurology, Chang Gung University College of Medicine, Kaohsiung,Taiwan.
Che-Wei
CW
Hsu
Chen-Hsien
CH
Lu
Ming-Jung
MJ
Chuang
Chi-Ren
CR
Huang
Yao-Chung
YC
Chuang
Nai-Wen
NW
Tsai
Shu-Fang
SF
Chen
Chung-Chih
CC
Chang
Wen-Neng
WN
Chang
D000293:Adolescent; D000328:Adult; D001259:Ataxia / Q000209:etiology; D001922:Brain Abscess / Q000150:complications / Q000473:pathology*; D002531:Cerebellum / Q000382:microbiology* / Q000473:pathology*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006261:Headache / Q000209:etiology; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged