A Solitary Abscess of the Medulla oblongata

Abstract

A neuropathological description is presented of a solitary giant abscess located in the oblongate medulla of a child aged two. This abscess destroyed almost all the morphological structures in the medulla and caused considerable constriction and translocation of the IVth ventricle. Apart from the exceptional occurrence of an abscess in this brain region, the interesting features of this case are the slow development of the abscess (probably 8 months) and the existence of a well-formed connective tissue capsule, demarcating the lesion from its surroundings. The diagnostic difficulties and clinical and histopathological correlation are also discussed.

Brainstem abscess and the syndrome of acute tegmental encephalitis

“…CSF changes have been documented in 22 cases [8,11,15,17,18,20,21,24,28,29,32,33,34,36,[40][41][42], and this report]. The CSF pressure was measured in 14 patients and was reported as normal.…”

“…Only 55 cases of brainstem abscess appear in the literature 17,8,11,17,21,24,34,36,37,40,451. This entity is not as rare as these reports would indicate since 1 brainstem abscess should be encountered for every 5,000 autopsies [12].…”

Bacterial abscess of the medulla oblongata

“…[2][3][4][5][6][7] Four patients were diagnosed postmortem. 3,4,6,7 There has been one report each of a medullary abscess treated with medical therapy alone and with combined medical and surgical therapy, respectively. 2,5 Good outcomes were obtained in both cases.…”

“…1 An isolated abscess of the medulla is rarer, with only six cases reported in the English literature, to the best of our knowledge. [2][3][4][5][6][7] Most cases are diagnosed at autopsy. Because of their proximity to cranial nerve nuclei and multiple neural tracts as well as the limited space for expansion, these lesions can cause significant morbidity and mortality.…”

Multiple Abscesses in the Frontal, Temporal and Brainstem regions in a 4.5-year-Old Girl- An Illustrative Case Report

“…To the best of our knowledge, there have been only 27 published cases of pediatric brainstem abscesses. [1,2,8,[10][11][12][13][14][15][16][17]19,[22][23][24][26][27][28][29]33,[35][36][37][38][39]41] We report the 28 th case of a pediatric patient with acute lymphoblastic leukemia (ALL) that developed multiple suppurative intracranial collections including a pontine abscess that was treated with a surgical intervention and a course of antibiotics. To the best of our knowledge, this is the 1 st reported case of pediatric brainstem abscess associated with ALL.…”