Focal Intracranial Infections

Heilpern, Katherine L.; Lorber, Bennett

doi:10.1016/s0891-5520(05)70331-7

Cited by 70 publications

(45 citation statements)

References 59 publications

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“…The mortality rate in patients with HHT and BA has been described to be as high as 41% and similar to that in patients without HHT [11,] although such figures are changing with improvement in diagnosis and treatments [27, 28]. All patients in our series survived the episode of BA, although this could be a survival bias.…”

Section: Discussionsupporting

confidence: 48%

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Gargiulo

Guastamacchia²,

Resta³

et al. 2006

Respiration

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Hereditary hemorrhagic telangiectasia (HHT) is a systemic angiodysplasia inherited as an autosomal dominant disease. Patients with HHT and pulmonary arteriovenous malformations (PAVMs) are at increased risk for brain abscess (BA), a potentially preventable condition as effective treatment for PAVMs is available. In a center dedicated to HHT, a history of BA was found in 6 out of 128 patients with a definite diagnosis: herewith, their histories are reported focusing on mistakes in the diagnosis and management of the disease. Patients with PAVMs and BA had a higher mean hemoglobin concentration (15.1 g/dl vs. 12.2 g/dl, p < 0.006 by Student’s t test) compared to patients with PAVMs alone. Other clinical features (genetics, bacteriology, types of PAVMs, treatments, outcomes) are also discussed. Prompt diagnosis and screening for visceral involvement is pivotal for HHT patients and their relatives.

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Section: Discussionsupporting

confidence: 48%

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Gargiulo

Guastamacchia²,

Resta³

et al. 2006

Respiration

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“…Usually, nonsurgical management of subdural empyema has only been successful if the fluid collection is small or if the patient is neurologically stable and alert, and rapidly improves with only antibiotic treatment. 4,5) However, under other conditions, subdural empyema could be a neurological emergency. The choice of burr hole surgery or craniotomy for surgical intervention remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Subdural Empyema Treated With a Wide Decompressive Craniectomy and Continuous Irrigation. Case Report.

Wada

Kubo

Asano

et al. 2002

Neurol. Med. Chir.(Tokyo)

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A 56-year-old male presented with fulminant subdural empyema manifesting as rhinorrhea, periorbital cellulitis, fever, convulsions, and consciousness disturbance. Neuroimaging showed pansinusitis with skull destruction and extensive subdural empyema. Decompressive craniectomy, irrigation of the empyema, and subdural drainage were performed. Endoscopic sinus surgery was performed to remove the source of infection at the same time. Streptococcus milleri was cultured from the pus. Continuous irrigation of the subdural space with saline containing gentamicin for 7 days resulted in prompt elimination of pus and debris. The patient was discharged with only a slight neurological deficit.

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“…Epidural abscesses progress slowly than subdural empymas and are diagnosed early [13,16] hence have better outcomes in management [11,14,16] . -Subdural empyma spreads rapidly and freely within a preformed space so it has a more culminant acute presentation with early neurologic deficits [10,17] .…”

Section: Site Of Lesionmentioning

confidence: 99%

Complications of Sinusitis, Management with Limited Resources-: A Report of Two Cases with a Review of the Literature

Sharma¹,

Internationals²

2017

IJNBD

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Unusual clinical presentations of intra cranial suppurative complication of sinusitis make it difficult to be to be diagnosed and make it a challenging task. Even in present time this pathology is known to produce significant morbidity and mortality. A short review of the literature on ICS has been done with our experience of two cases who had varying clinical presentations and inspite of their management with limited available resources, both the cases recovered fully with limited morbidity. The first case, a 12 years old boy had no clinical evidence of sinusitis but had high fever, signs of increased intra cranial pressure, orbital cellulites and abscesses on left upper eye lid and on same side of forehead. The CT scan revealed Fronto-Maxillary sinusitis, periorbital cellulites, lid and forehead abscesses along with oedema in brain for which an external Fronto-Ethmoido-Maxillary antrostomy [Lynch-Howarth operation] was done along with drainage of extra cranial abscesses in the eyelid and forehead.The second case, a 21 years old female, known to have nasal allergies had a high fever, right eye congested and proptosed and had signs of increased ICP. The CT and MRI revealed that she had a subdural empyma, Frontal sinusitis and a periorbital Cellulites. The subdural empyma was drained by a neuro-surgeon and the sinus abscesses were drained [Lynch Howarth operation] by an Otolaryngologist, at the same time. Both the patients recovered in 4 to 6 week. In conclusion, the diagnosis of ICS requires a high index of suspicion and early radiographic imaging [CT/MRI] of the head and paranasal sinuses. An aggressive medical therapy is indicated and it may require drainage of the sinus abscess and the intra cranial abscess, at the same time.

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Focal Intracranial Infections

Cited by 70 publications

References 59 publications

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Fulminant Subdural Empyema Treated With a Wide Decompressive Craniectomy and Continuous Irrigation. Case Report.

Complications of Sinusitis, Management with Limited Resources-: A Report of Two Cases with a Review of the Literature

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