Ngo Taylor M, Okabe Anna, Nguyen Kailey B, Tong Anhtho, Chang Jason, Lui Forshing
Neurology, California Northstate University College of Medicine, Elk Grove, USA.
Neurology, Kaiser Permanente South Sacramento Medical Center, Sacramento, USA.
Cureus. 2023 Jul 6;15(7):e41463. doi: 10.7759/cureus.41463. eCollection 2023 Jul.
Brainstem abscesses are localized collections of pus or infected material within the brainstem, which can cause inflammation, tissue damage, and compression of adjacent structures. This can lead to a variety of symptoms, including headache, fever, and focal neurological deficits, among many others. Brainstem abscesses are potentially life-threatening and considered to be rare, and pontine abscesses are even rarer. Both are often caused by the spread of infection from nearby structures like the middle ear, sinuses, and mastoid air cells, but they can also result from distant infectious sites that have spread to the bloodstream. Ambiguous clinical presentation can delay appropriate care and lead to poorer outcomes. We present a rare case of pontine abscess in a 54-year-old male with both undetermined causal origins and unclear infectious signs, namely, the lack of fever, fatigue, and chills. We will discuss the etiologies, diagnosis, and treatment of cryptogenic brainstem lesions in this case report.
脑干脓肿是脑干内的局限性脓液或感染性物质聚集,可引起炎症、组织损伤及对邻近结构的压迫。这可导致多种症状,包括头痛、发热及局灶性神经功能缺损等。脑干脓肿有潜在生命危险且被认为较为罕见,脑桥脓肿则更为罕见。两者通常由中耳、鼻窦及乳突气房等邻近结构的感染扩散引起,但也可源于远处感染部位经血行播散所致。临床表现不明确可延误恰当治疗并导致更差的预后。我们报告一例54岁男性的罕见脑桥脓肿病例,其病因不明且感染征象不明确,即无发热、乏力及寒战。我们将在本病例报告中讨论隐源性脑干病变的病因、诊断及治疗。