| First-line stereotactic treatment of thalamic abscesses: report of three cases and review of the literature. | |
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MedLine Citation:
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PMID: 19701873 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Solitary pyogenic thalamic and basal ganglia abscesses are relatively uncommon. Even if widespread antibiotic therapy and modern imaging technologies combined with minimally invasive techniques have improved the outcome in patients with brain abscesses, this is counterbalanced by an increasing population of immunocompromised patients. Basal ganglia, thalamic, brainstem or multiple abscesses are usually of hematogenous origin with an underlying source of infection which can include congenital heart disease, thoracic sepsis or, less frequently, an odontogenic or otogenic source. However, no evident foci of sepsis or predisposing factors may be found. Only a few studies are reported in the literature, because midline abscesses are usually included in studies dealing on the treatment of abscesses in general. Different treatment options and the timing of treatment are described. We report our experience in 3 consecutive cases of thalamic abscess, treated by stereotactic puncture as the first step, followed by histological analysis, external drainage and targeted intrathecal and systemic antibiotic therapy. Deep-seated abscesses seem to behave differently as they are associated with an increased risk of intraventricular rupture and antibiotic resistance, a fact which justifies a more aggressive and immediate surgical treatment. We review the literature on this topic in the last 20 years. |
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Authors:
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G M Callovini; A Bolognini; V Gammone; G Petrella |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-08-21 |
Journal Detail:
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Title: Central European neurosurgery Volume: 70 ISSN: 1868-4912 ISO Abbreviation: Cent Eur Neurosurg Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-24 Completed Date: 2009-11-16 Revised Date: 2012-03-23 |
Medline Journal Info:
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Nlm Unique ID: 101501500 Medline TA: Cent Eur Neurosurg Country: Germany |
Other Details:
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Languages: eng Pagination: 143-8 Citation Subset: IM |
Copyright Information:
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Georg Thieme Verlag KG Stuttgart New York. |
Affiliation:
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Department of Neurosurgery, Ospedale S. Spirito, Roma 00135, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anemia, Hemolytic, Autoimmune / complications, therapy Brain Abscess / complications, surgery*, ultrasonography Cognition Disorders / etiology Female Glasgow Coma Scale Humans Magnetic Resonance Imaging Male Neurosurgical Procedures / methods* Paresis / etiology Stereotaxic Techniques* Suction Thalamic Diseases / complications, surgery*, ultrasonography Thalamus / ultrasonography |
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