Neurosurgical approach to the treatment of otorhinogenic brain abscess (a clinical case)

Abstract

Cerebral abscesses are one of the most serious pathologies of the central nervous system. At the moment, despite the prevalence of neuroimaging techniques, a great number of antibacterial drugs, and a variety of surgical treatment methods, the likelihood of fatal outcome still exists, which is influenced by the patient’s state of health and a delayed diagnosis. The article presents statistical data on this pathology. The authors detailed the etiology and pathogenesis of cerebral abscesses, noting the role of streptococcal infection. Four stages of cerebral abscess were characterized: early and late cerebritis, and early and late capsule formation. The article presents several classifications of brain abscesses: by localization, by volume, by relation to the meninges and brain matter, and by the progression speed. The presence of mainly non-specific symptoms in the clinical picture, the most widespread being headache on the side of lesion, was also noted. The authors described characteristic symptoms in various cases of abscess localizations: in lesions of frontal, temporal, and parietal lobes, and localization of the malignant process in the brain stem. A clinical case of a cerebral abscess in a teenager was used to describe the methods of neuroimaging and surgical treatment of this pathology, as well as to characterize the neurological status before and after surgery. The author used the methods of decompressive craniectomy for surgical treatment of the brain abscess formation. An essential part of postoperative treatment is rehabilitation measures, as the majority of patients still have neurological deficit preserved.