title: Brain abscess following intra-arterial thrombolytic treatment for acute brain ischemia.
abstract: Brain abscess formation is a rare complication of intracranial endovascular treatment. To our knowledge, all previous reports of brain abscess formation have been associated with treatments involving the introduction of foreign materials. A 75-year-old man was admitted to hospital for acute stroke. Cerebral angiography revealed occlusion of the left middle cerebral artery (MCA) at the origin of the M2 segment. Intra-arterial thrombolytic therapy was administered but a hemorrhagic event occurred during this process. A brain CT scan revealed a hematoma extending from the left basal ganglia to the left frontal lobe and expansion of the infarct in the left MCA territory. A brain abscess at the hemorrhagic site developed 3 months after symptom onset. This is the first report of a patient with brain abscess formation following intra-arterial thrombolytic treatment. It is important to ensure aseptic technique during endovascular procedures irrespective of the involvement of foreign materials.
authors.affiliation: Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, 2-1-14, Hoenzaka, Chuo-ku, Osaka 540-0006, Japan. kyama@onh.go.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishihara
authors.forename: Shin
authors.initials: S
authors.lastname: Nakajima
authors.forename: Mami
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology; D057510:Endovascular Procedures / Q000009:adverse effects; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006406:Hematoma / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D000077731:Meropenem; D013845:Thienamycins / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D005343:Fibrinolytic Agents; D013845:Thienamycins; D014568:Urokinase-Type Plasminogen Activator; D000077731:Meropenem