Secondary Cryptogenic Brain Abscess with Cerebral Hernia During Absorption Stage of Cerebral Hemorrhage: Case Report and Literature Review
Peng Zou, Zhenhui Gao, Wensheng Ren, Jian Liu
Introduction: Brain abscess is a known complication of surgically treated intracerebral hemorrhage (ICH), but it is exceptionally rare that it occurs at the same site of a nonoperated ICH.This paper will report this special case, and present a literature review.
Patient concerns: A 62-year-old man with cerebral hemorrhage(about 25ml) in the right temporal occipital lobe was clearly conscious and initially treated conservatively.
Interventions: After 36 days of conservative treatment, the state of consciousness became worse, and imaging showed brain abscess with cerebral hernia at the same site of a nonoperated ICH. An emergency craniocerebral abscess resection was performed.
Outcomes: Postoperative pathology confirmed acute suppurative inflammation and necrosis, after symptomatic treatment successfully discharged.
Conclusion: There should be a high index of suspicion for a brain abscess following an intracerebral hemorrhage if the clinical and radiological picture differs from the expected course of a resolving hematoma.
Abbreviations: ICH=intracerebral hemorrhage, GCS=glasgow coma scale, CSF= cerebrospinal fluid, BBB=blood-brain barrier