Rajshekhar V, Chandy M J
Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India.
Neurosurgery. 1994 Feb;34(2):368-71; discussion 371. doi: 10.1227/00006123-199402000-00025.
The brain stem is an unusual location for a pyogenic abscess. We report a case of a brain stem abscess in a 5-year-old boy with tetralogy of Fallot that was refractory to conservative medical therapy but was cured after a single computed tomographic-guided stereotactic aspiration and appropriate antibiotic therapy. The remarkable features in this case were the extremely large size of the abscess (3.2 cm in diameter), occupying the full vertical extent of the brain stem and containing 15 ml of pus. We believe this is the first report of a favorable outcome in a cardiogenic brain stem abscess. The value of computed tomographic-guided stereotactic surgery in the management of this lethal condition is documented with a review of the relevant literature.
脑干是化脓性脓肿的一个不寻常发病部位。我们报告一例5岁法洛四联症男孩发生脑干脓肿的病例，该病例对保守药物治疗无效，但在单次计算机断层扫描引导下立体定向抽吸及适当抗生素治疗后治愈。该病例的显著特点是脓肿极大（直径3.2厘米），占据脑干的整个垂直范围，且含有15毫升脓液。我们认为这是心源性脑干脓肿取得良好预后的首例报告。通过回顾相关文献，证明了计算机断层扫描引导下立体定向手术在治疗这种致命疾病中的价值。
