Even though they are known complications of surgically treated intracerebral hemorrhages (ICH), the presence of a brain abscess at the site of an untreated ICH is a rare event. Such cases may result from haematogenous spread from distant foci or contiguous sites and are often preceded by episodes of sepsis and local infection.

There is a report a case of a 49-year old man presenting with a brain abscess 13 weeks after a spontaneous ICH, without previous episodes of sepsis and with a suspected septic arthritis 2 weeks after abscess drainage 1).


Brain abscess is a known complication of surgically treated intracerebral hemorrhage (ICH), but it is exceptionally rare that it occurs at the same site of a nonoperated ICH. Such cases may result from hematogenous spread from distant foci (pneumonia, infectious endocarditis) or contiguous sites.

A case of 75-year-old woman presenting with a brain abscess 6 weeks after a nonoperated ICH. As the patient suffered from pneumonia during the course of ICH, the authors suspected that the brain abscess might originate from the pneumonia via hematogenous spread. The awareness of brain abscess formation at the site of ICH is of great importance for early diagnosis and prompt treatment. 2).


Dashti et al., report the case of a 30-year-old woman who presented with a cerebral abscess at the site of a recent intraparenchymal hemorrhage 3).


1)
Rigante L, Tufo T, Scoppettuolo G, Donato C, Mangiola A. Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: a case report and literature review. Turk Neurosurg. 2013;23(6):835-9. doi: 10.5137/1019-5149.JTN.6591-12.2. PubMed PMID: 24310475.
2)
Liu K, Yang C, Zhang Y, Yuan X, Xiao H, Bai Y, Xi B. Brain Abscess Following Intracerebral Hemorrhage in a Patient With Pneumonia. J Craniofac Surg. 2016 Oct 14. PubMed PMID: 27755420.
3)
Dashti SR, Baharvahdat H, Sauvageau E, Chang SW, Stiefel MF, Park MS, Spetzler RF, Bambakidis NC. Brain abscess formation at the site of intracerebral hemorrhage secondary to central nervous system vasculitis. Neurosurg Focus. 2008;24(6):E12. doi: 10.3171/FOC/2008/24/6/E12. PubMed PMID: 18518742.
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