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Brain Abscess and Ventriculitis Associated with Entrapment of the Lateral Ventricle Appearing More Like Remarkable Brain Edema than Ventricular Dilatation : a case report Takao YASUHARA 1 , Minoru NAKAGAWA 1 , Yoshinori TERAI 1 , Kimihiro YOSHINO 1 , Shunichiro FUJIMOTO 1 , Noboru KUSAKA 2 1Department of Neurosurgery, Kagawa Rosai Hospital 2Department of Neurological Surgery, Okayama University School of Medicine Keyword: brain abscess , entrapment of the lateral ventricle , brain edema , Hounsfield Unit pp.151-156
Published Date 2001/2/10
DOI https://doi.org/10.11477/mf.1436902013
  • Abstract
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We present a case with brain abscess associated with entrapment of the lateral ventricle appearing morelike remarkable brain edema in the temporo-occipital lobe than ventricular dilatation. A 72-year-old mansuffering from headache and vomiting visited our clinic. CT and MRI showed brain abscess in the rightparieto-occipital lobe, associated with ventriculitis. Lumbar puncture also revealed purulent meningitis.Both symptoms and CSF findings improved after administration of antibiotics. The improved conditioncontined for two months after admission, but disturbed consciousness and left hemiparesis than appeared.MRI and CT showed entrapment of the lateral ventricle and brain edema of the right temporo-occipital re-gion without ventricular dilatation. Because brain edema was thought to be caused by transudate of theCSF through the ventricular wall, lobectomy of the right temporal lobe and opening of the temporal hornwere carried out. Although left hemiparesis and disturbed consciousness and brain edema disappearred af-ter the operation, subdural effusion appeared. Using a subdural-peritoneal shunt, the subdural effusion wasprevented and disappeared.

In this case, we thought Hounsfield Unit (HU) of the brain edema caused by transudate of CSF throughthe ventricular wall (12.6) was markedly lower than that of so-called vasogenic edema (25.1) due to activeinflammation. Measurement of the HU seemed to be a useful means to differentiate the types of brain ede-ma in this situation from that of vasogenic edema caused by brain abscess, and thus a means for selectionof the appropriate treatment.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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