Brain abscesses in neonates: Neurosonographic diagnosis and long-term follow-up

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ƭǺǥǩǟǗǢǗǩǚapsces mozga; purulentni meningitis; neurosonografija

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BIBLID: 0370-8179, 133(2005) 7-8 p. 343-347 UDC: 616.831-002.3-053.2-073.43

SLIKA 1. Ventrikulitis (neurosonogram – koronalni prikaz).

FIGURE 1. Ventriculitis (neurosonogram – coronal section).

SLIKA 2.ƢǡǣǨǗǣǞǠǙǔǑǤǗǞǡǠǢǠǡǑǢǚǹǗǤǑǝǟǗǢǗǔǚǹǗ ǟǗǥǢǠǣǠǟǠ -gram – koronalni prikaz).

FIGURE 2. Brain abscess in the temporoparietal region

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SLIKA 3.ƢǡǣǨǗǣǞǠǙǔǑǦǢǠǟǤǑǝǟǗǢǗǔǚǹǗ ǟǗǥǢǠǣǠǟǠǔǢǑǞ=ǡǑǢǑ -sagitalni prikaz).

FIGURE 3. Brain abscess in the frontal region (neurosonogram –

para-sagittal section).

SLIKA 4. ƸǚǖǢǠǨǗǦǑǝǥǣ ǡǠǣǝǗ ǠǡǗǢǑǨǚǹǗ ǦǢǠǟǤǑǝǟǠǔ ǑǡǣǨǗǣǑ

(neurosonogram – koronalni prikaz).

FIGURE 4. Hydrocephalus after operation of brain abscess in the

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SLIKA 5.ƢǡǣǨǗǣǞǠǙǔǑǤǗǞǡǠǢǠǡǑǢǚǹǗǤǑǝǟǗǢǗǔǚǹǗ=ǣǚǟǖǢǠǞǞǑ -se (neurosonogram – koronalni prikaz).

FIGURE 5. Brain abscess in the temporoparietal region – effect of

mass (neurosonogram – coronal section).

SLIKA 6. Stawe posle operacije apscesa mozga (neurosonogram – koronalni prikaz).

FIGURE 6. Condition after operation of brain abscess

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LITERATURA

1. Renier D, Flandin C, Hirsch E, Hirsch JF. Brain abscess in neonate. A study of 30 patients. J Neurosurg 1988; 69(6):877-82.

2. Carre M, Sarlangue J, Baronnet R, Nicolau A, Demarquez JL. Cere-bral abscess caused by Proteus mirabilis in the neonatal period. Arch Fr Pediatr 1987; 44(10):871-4.

3. Fumado I, Baraibar R, Campistol J, Costa JM. Neonatal meningitis by Proteus mirabilis with cerebral abscess. An Esp Pediatr 1985; 23(3):201-4.

4. Hervas JA, Ciria L, Henales V, Lopez P, de la Fuente A, Del Valle JM. Nonsurgical management of neonatal brain abscess due to Proteus mirabilis. Helv Paediatr Acta 1987; 42(5-6):451-6. 5. Sakata H, Maruyama S. Serratia marcescens brain abscess in

new-born. Kansenshogaku Zasshi 1998; 72(8):845-8.

6. Mahapatra AK, Pawar SJ, Sharma RR. Intracranial Salmonella infections: meningitis, subdural collections and brain abscess. A series of six surgically managed cases with follow-up results. Pedi-atr Neurosurg 2002; 36(1):8-13.

7. Han BK, Babcock DS, McAdams L. Bacterial meningitis in infants: sonographic findings. Radiology 1985; 154:645-50.

8. Rozmanic V, Ahel V, Dessardo S, et al. Sonographic detection of multiple brain abscesses in a newborn with IgA deficiency. J Clin Ultrasound 2001; 29(8):479-81.

9. Strowitzki M, Schwerdtfeger K, Steudel WI. Ultrasound-guided aspiration of brain abscesses through a single burr hole. Minim Invasive Neurosurg 2001; 44(3):135-40.

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12. Teixeira J, Zimmerman RA, Haselgrove JC, et al. Diffusion imag-ing in pediatric central nervous system infections. Neuroradiology 2001; 43(12):1031-9.

ABSTRACT

Brain abscesses were neurosongraphically diagnosed in 3 out of 44 neonates who had confirmed purulent meningitis. In two cases, the cause was Proteus mirabillis, whereas in one the cause could not be isolated. The ultrasound finding indicated abscess cavities localised in the frontal (in one case bilateral-ly) and temporal regions of the CNS. Neurosurgical interven-tions were carried out on all of the neonates who had abscess-es (including the evacuation of purulent cavity contents, and later on a ventriculoperitoneal shunt in two cases, because of the development of hydrocephalus). Follow-up on the operat-ed infants revealoperat-ed that one infant dioperat-ed at the age of 9 months; one, who had a bilateral abscess, demonstrated significant

neurodevelopmental retardation in the third month of his life (so far it has not been brought under control); while the third one, whom we monitored until the age of 2, displayed regular psychomotor development (preserved intellect, motor skills, sight, and hearing).

Key words: brain abscess; purulent meningitis; neurosonography

Slobodan OBRADOVIĆ

Nikole Pašića 12/1, 34000 Kragujevac Tel: 034 333 086

E-mail: slobob@ptt.yu

BRAIN ABSCESSES IN NEONATES: NEUROSONOGRAPHIC DIAGNOSIS AND

LONG-TERM FOLLOW-UP

Slobodan OBRADOVIĆ, Anđelka STOJKOVIĆ-ANĐELKOVIĆ, Biljana VULETIĆ, Marija RADOVANOVIĆ Paediatric Clinic, Clinical Hospital Centre, Kragujevac