Brain abscess in congenital cyanotic heart disease

Kagawa, Mizuo; Takeshita, Mikihiko; Yato, Seiji; Kitamura, Keigo

doi:10.3171/jns.1983.58.6.0913

Cited by 93 publications

(78 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5,9,12,15,23 The location of the bur hole is carefully selected in order to minimize the brain tissue traversed during the procedure. Aspiration of pus, while relieving the increased intracranial pressure, provides pus for culture and sensitivity determination.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses

Kocherry

Hegde

Sastry

et al. 2008

FOC

View full text Add to dashboard Cite

Object Intracranial abscesses located deep in the cerebral parenchyma and in eloquent regions are often difficult to manage surgically. The authors have attempted to analyze the efficacy of stereotactic aspiration in the management of these abscesses. Methods Cases involving 22 patients (including 9 children) with deep-seated and/or eloquent-region intracranial abscesses who underwent CT- or MR imaging–guided stereotactic aspiration between January 1995 and July 2001 were analyzed. Results A definite source of infection could be identified only in 9 of the cases. In 18 patients, the abscess was deep seated, whereas in the rest it was located in the eloquent cortex. Five patients had abscesses located in multiple sites. In 17 patients only 1 aspiration was required; in 5 others subsequent procedures were required. In the initial postaspiration CT, minor hemorrhage was noted in 3 patients not requiring further intervention. Antibiotics were administered for a period varying from 4 to 8 weeks following aspiration. An early recurrence (within 2 weeks of initial aspiration) was evident in 5 patients. All recurrent abscesses were reaspirated. In 2 patients new abscesses developed while the patients were still receiving antibiotic therapy. There were no late recurrences. In 1 patient ventriculitis developed, with subsequent hydrocephalus requiring a shunt insertion. Follow-up CT scans showed complete resolution of the abscess in all patients. There were no deaths. Conclusions Stereotactic aspiration is a useful management option for abscesses located in eloquent or inaccessible regions. Repeated aspiration should be considered in patients in whom the initial aspiration proves ineffective or partially effective. Complete resolution may require repeated stereotactic aspirations and continued antibiotic therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses

Kocherry

Hegde

Sastry

et al. 2008

FOC

View full text Add to dashboard Cite

show abstract

“…Though data are limited, one study estimated a 2% incidence over 13-years of follow-up. The most commonly associated CCHD lesions were tetralogy of Fallot (TOF ¼ 61.2%) and TGA (9.6%) [15,16]. Right-to-left shunting carries any increased risk of infective endocarditis and may predispose to brain abscess by both allowing arterial bacteremia (due to bypass of the normal phagocytic filtering ability of the lungs) and a focal ischemic nidus for infection (due to hyperviscosity) [16][17][18].…”

Section: Cerebral Complications Of Cyanosismentioning

confidence: 99%

Extra-cardiac manifestations of adult congenital heart disease

Gaeta

Ward

Krasuski

2016

Trends in Cardiovascular Medicine

View full text Add to dashboard Cite

a b s t r a c tAdvancement in correction or palliation of congenital cardiac lesions has greatly improved the lifespan of congenital heart disease patients, resulting in a rapidly growing adult congenital heart disease (ACHD) population. As this group has increased in number and age, emerging science has highlighted the systemic nature of ACHD. Providers caring for these patients are tasked with long-term management of multiple neurologic, pulmonary, hepatic, renal, and endocrine manifestations that arise as syndromic associations with congenital heart defects or as sequelae of primary structural or hemodynamic abnormalities. In this review, we outline the current understanding and recent research into these extra-cardiac manifestations.Key words: Cardiovascular disease, Adult congenital heart disease, Pulmonary hypertension. Advances in the diagnosis and management of congenital heart disease (CHD) over the past several decades have greatly improved longevity and quality of life in the CHD population. Palliative or corrective interventions are now available for nearly every type of congenital cardiac lesion, and approximately 90% of affected children now survive to adulthood [1]. Adults with CHD (ACHD) already outnumber pediatric CHD patients, and this population is expected to grow by 5% per year [1,2]. Strikingly, the median age of severe CHD patients has increased from 11 years in 1985 to 25 years in 2010 [3]. Continued improvement in CHD interventions means that new (and more complex) populations will likely reach adulthood in the coming years.Practitioners who take care of adults with CHD are often charged with the delivery or coordination of comprehensive care for these complex patients, including the management of manifestations and complications that arise later in life. ACHD has many extra-cardiac effects, both as syndromic associations with congenital heart defects, or more commonly, as sequelae of primary structural or hemodynamic abnormalities. The role of genetic predilection remains undefined for nearly all extra-cardiac complications, though their incidence has clearly risen over the past decades. Indeed, more than a third of hospital admissions for ACHD patients are now for noncardiovascular reasons [4]. Optimal care of ACHD patients, therefore, mandates a thorough understanding of its multiorgan system manifestations. Herein, we will review current understanding of the most common manifestations of ACHD organized by the affected organ systems. Neurologic/neuropsychiatric Cerebrovascular complicationsA recent study quantified the strikingly high rates of stroke in ACHD [5]. Among nearly 30,000 ACHD patients, 8.9% of men http://dx

show abstract

“…These low-perfusion areas commonly occur in the junction of gray and white matter, and they are prone to seeding by microorganisms that may be present in the bloodstream. 28,56 The hematogenous mode of spread accounts for the subcortical location as well as the multiple number of abscesses often encountered in these patients. 7,12,22,57 Streptococcus milleri was the most common organism isolated from the abscess in patients with cyanotic heart disease in one series.…”

Section: Cyanotic Heart Disease and Brain Abscessmentioning

confidence: 99%

Management of brain abscess: an overview

Moorthy

Rajshekhar²

2008

FOC

113

130

View full text Add to dashboard Cite

✓ Recent advances in neuroimaging have resulted in a marked decrease in morbidity and death due to brain abscesses. The advent of computed tomography–guided stereotaxy has reduced morbidity in patients with deep-seated abscesses. Empirical therapy is best avoided in the present era, particularly given the availability of stereotactic techniques for aspiration and confirmation of diagnosis. Despite these advances, management of abscesses in patients with cyanotic heart disease and in immunosuppressed patients remains a formidable challenge. Unusual as well as more recently recognized pathogens are being isolated from abscesses in immunosuppressed patients. The authors provide an overview of the management of brain abscesses, highlighting their experience in managing these lesions in patients with cyanotic heart disease, stereotactic management of brain abscesses, and management of abscesses in immunosuppressed patients.

show abstract

Brain abscess in congenital cyanotic heart disease

Cited by 93 publications

References 18 publications

Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses

Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses

Extra-cardiac manifestations of adult congenital heart disease

Management of brain abscess: an overview

Contact Info

Product

Resources

About