| Diagnostic and management of pediatric brain stem abscess, a case-based update. | |
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MedLine Citation:
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PMID: 21626005 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Authors report their experience of a pediatric brain stem abscess with a literature review. METHODS: A 2.5-year-old girl first displayed bacterial otitis 3 months before admission. Diagnosis of brain stem abscess was delayed, despite plethoric neurological signs. She complained of right hemiparesis, headache, squint, dysphagia, and false way inhalation pneumopathy. Brain magnetic resonance imaging revealed presence of an abscess in the pons, prompting for a microsurgical pus aspiration. Postoperative course was regular with a total neurological recovery. Clinical and radiological screening showed progressive regression of the pontine lesion after 4 months, despite persistence of a mild contrast enhancement. Present case is the 18th pediatric brain stem abscess reported in literature. RESULTS: Mean age of occurrence is 8.1 ± 4 years (range 0.75-16) without gender predominance. High morbidity is typical and essentially involves motor functions. The most common clinical signs are raised intracranial pressure, motor limbs deficit, and cranial nerve palsies. Fever was found in 10 out of 18 cases (56%). Three patients received conservative medical treatment. Three patients underwent stereotactic aspiration and 12 others underwent microsurgical aspiration or excision. No mortality was reported since the eighties. However, morbidity is still high. CONCLUSION: High clinical index of suspicion is necessary to improve functional outcome. Stereotactic-guided or microsurgical aspiration are still good therapeutic options. The rarity of pediatric brain stem abscesses and the need of optimal management make this case-based update very peculiar. |
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Authors:
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Houssine Ghannane; Mehdi Laghmari; Khalid Aniba; Mohammed Lmejjati; Saïd Ait Benali |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-6 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: - ISSN: 1433-0350 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-5-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neurosurgery, UHC Mohammed VI, Faculty of Medicine, Cadi Ayyad University, Marrakesh, Morocco. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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