DO Udoh1. 1. Department of Surgery, University of Benin Teaching Hospital, Benin, Nigeria.
Abstract
BACKGROUND: Intracranial abscess, though uncommon, have relatively higher occurrence in low socio-economic settings where previous antibiotic abuse and lack modern culture techniques makes isolation of organisms difficult. Diagnosis and treatment are further delayed by a poor referral system and low index for suspicion. Tuberculoma, cannabis abuse, ventriculo-peritoneal shunt catheters and cancer therapy are presented here as unusual causes of intracranial abscesses. AIMS & OBJECTIVES: To highlight less commonly encountered causes of an uncommon, but dreaded, neurosurgical condition, their diagnosis and treatment approaches. CASE REPORTS: Five patients who had surgical evacuation of intracranial abscesses not due to pathology from the more familiar spread from sinusitis, mastoid, middle ear, post-meningitic or post -traumatic aetiology are presented. Contrast computerised tomography (CT) brain scan was essential in clinching the diagnosis and determining the management options. CONCLUSIONS: Persistent headaches or features of intracranial involvement (in patients undergoing treatment for other conditions) should always warrant CT of the brain. However, there are several differential diagnoses of ring-enhancing lesions on CT which have to be excluded when considering an abscess.
BACKGROUND: Intracranial abscess, though uncommon, have relatively higher occurrence in low socio-economic settings where previous antibiotic abuse and lack modern culture techniques makes isolation of organisms difficult. Diagnosis and treatment are further delayed by a poor referral system and low index for suspicion. Tuberculoma, cannabis abuse, ventriculo-peritoneal shunt catheters and cancer therapy are presented here as unusual causes of intracranial abscesses. AIMS & OBJECTIVES: To highlight less commonly encountered causes of an uncommon, but dreaded, neurosurgical condition, their diagnosis and treatment approaches. CASE REPORTS: Five patients who had surgical evacuation of intracranial abscesses not due to pathology from the more familiar spread from sinusitis, mastoid, middle ear, post-meningitic or post -traumatic aetiology are presented. Contrast computerised tomography (CT) brain scan was essential in clinching the diagnosis and determining the management options. CONCLUSIONS: Persistent headaches or features of intracranial involvement (in patients undergoing treatment for other conditions) should always warrant CT of the brain. However, there are several differential diagnoses of ring-enhancing lesions on CT which have to be excluded when considering an abscess.