Département d'otoneurochirurgie, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2010 Mar;127(1):46-8. doi: 10.1016/j.anorl.2010.02.011. Epub 2010 Apr 23.
Routine vestibular schwannoma surgery can result in serious and potentially lethal infectious complications. A high degree of vigilance is necessary to diagnose these uncommon infections and in case of postoperative neurological symptoms, brain magnetic resonance imaging should be performed to eliminate a brain abscess. In some cases, the final diagnosis is not the expected one.
A 39-year-old man presented three months postoperatively after a vestibular schwannoma removal by translabyrinthin approach with a rapid and progressive history of headaches, confusion, and left hemi paresis with fever. The brain CT and MRI were in favour of a delayed postoperative frontal abscess.
A biopsy under stereotactic guidance was performed. Histopathologic examination revealed WHO grade 4 glioblastoma multiforme.
Symptoms and signs of glioblastoma multiforme are congruent with brain abscess. Its rapid evolution, the normality of the first magnetic resonance imaging, and its radiological aspect made it a differential diagnosis of a postoperative brain abscess and should be systematically researched.
常规听神经鞘瘤手术可导致严重且潜在致命的感染并发症。需要高度警惕以诊断这些罕见的感染，如果术后出现神经系统症状，应进行脑磁共振成像以排除脑脓肿。在某些情况下，最终诊断并非预期的诊断。
一名 39 岁男性在经迷路切除听神经鞘瘤术后 3 个月出现进行性头痛、意识模糊和左侧半身无力伴发热。脑 CT 和 MRI 提示术后迟发性额窦脓肿。
在立体定向引导下进行了活检。组织病理学检查显示为世界卫生组织 4 级多形性胶质母细胞瘤。
多形性胶质母细胞瘤的症状和体征与脑脓肿一致。其快速进展、首次磁共振成像正常以及影像学表现使其成为术后脑脓肿的鉴别诊断，应系统研究。
