Fulminant ependymitis following intraventricular rupture of brain abscess

Inamasu, Joji; Kuramae, Takumi; Tomiyasu, Kazuhiro; Nakatsukasa, Masashi

doi:10.1007/s10156-010-0201-2

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…Intraparenchymal brain abscesses located near the cerebral ventricles, for which urgent surgical intervention is required to prevent intraventricular rupture, are not infrequent in clinical practice [ 1 ]. In contrast, primary intraventricular brain abscess is rare, with less than 10 cases reported in the medical literature [ 2 , 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rupture of a brain abscess into the cerebral ventricles is a devastating event, resulting in high mortality and morbidity. Patients with a ruptured abscess exhibit rapid neurological deterioration on account of acute ventriculitis [ 1 ]. Therefore, preemptive surgery to prevent rupture has been recommended for patients with an intraparenchymal brain abscess located near the ventricles [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with a ruptured abscess exhibit rapid neurological deterioration on account of acute ventriculitis [ 1 ]. Therefore, preemptive surgery to prevent rupture has been recommended for patients with an intraparenchymal brain abscess located near the ventricles [ 1 ]. In contrast, primary intraventricular brain abscesses have rarely been reported in the literature [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

et al. 2015

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Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI) revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative) is more appropriate in patients with primary intraventricular brain abscesses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

et al. 2015

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“…Though conservative management can be initially started, ultimately surgical drainage and evacuation followed by ventriculo-peritoneal shunting is the defi nite mode of treatment. 5,6 We planned for intraventricular drainage of the abscess preoperatively and as planned it was brain abscess coming out under pressure. Through irrigation was done during and after surgery regularly.…”

Section: Discussionmentioning

confidence: 99%

A Case of Primary Intraventricular Brain Abscess in a Child: A Challenge to Conquer

Bajracharya¹,

Shrestha²,

Singh³

et al. 2016

Nep J Neurosci

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Primary intraventricular brain abscess is a rare entity. Not many cases are reported yet. Moreover, proper guidelines for the treatment, conservative treatment or surgery, has not yet been established. Its outcome is also unpredictable and usually poor.We present a 11-year-old girl with wide spread intraventricular brain abscess. There was no obvious cause for the abscess formation. Cardiac status was normal by history and ECHO. She was treated surgically with external ventricular drainage (EVD). There was significant improvement after EVD. Intraventricular flushing was done with the solution of injection Gentamycin and hydrocortisone. However, the patient expired while planned for discharge from the hospital due to sudden cardiac arrest.A bigger study is needed to assess the various factors of intraventricular brain abscess including epidemiology, treatment, outcome etc in the Nepalese context.Nepal Journal of Neuroscience 12:88-90, 2015

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“…[ 10 11 ] Only one article has described the administration of intraventricular vancomycin as a treatment for IVROBA. [ 14 ] Given the paucity of literature, skepticism persists regarding the employment of intraventricular antibiotics specifically for the treatment of IVROBA. To our knowledge, this is the second report involving intraventricular vancomycin for the treatment of IVROBA in a patient persistently having positive cerebrospinal fluid (CSF) cultures despite prolonged use of IV antibiotics; once intraventricular vancomycin was employed, the patient demonstrated remarkable improvement without perceivable side effects.…”

Section: Introductionmentioning

confidence: 99%

Good outcomes with the intraventricular vancomycin therapy in a patient with ruptured brain abscesses

Doan

Nguyen

et al. 2018

Asian J Neurosurg

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Brain abscesses are associated with high morbidity and mortality rates. In particular, patients with intraventricular rupture of brain abscess (IVROBA) exhibit mortality rates up to 85%. Treatment options are lacking for IVROBA, once patients become refractory to intravenous antibiotics and surgical drainage. Limited data exist regarding the risks and benefits of intraventricular therapy in such a scenario. We report a patient with IVROBA, who deteriorated while on systemic antibiotics; once intraventricular vancomycin was employed, the patient demonstrated remarkable improvement without perceivable side effects. This case suggests that intraventricular vancomycin may be a safe, effective, and viable option for the treatment of IVROBA, especially for patients becoming refractory to systemic antibiotics.

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Fulminant ependymitis following intraventricular rupture of brain abscess

Cited by 9 publications

References 9 publications

Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

A Case of Primary Intraventricular Brain Abscess in a Child: A Challenge to Conquer

Good outcomes with the intraventricular vancomycin therapy in a patient with ruptured brain abscesses

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