A29 Development Of Posttraumatic Brain Abscess Following A Fall

Abstract

INTRODUCTION

Brain abscess is a rare but serious complications that can arise following a trauma. Bacterial contamination of the intracranial space after penetrating injury or skull fracture is common but the incidence of posttraumatic brain abscess is low and such complications associated with blunt trauma is exceedingly rare. Delayed presentation remained a challenge as it comes with serious complications and outcomes.

CASE DESCRIPTION

A 1 year 9 months old boy previously healthy presented with multiple episodes of seizures associated with fever several weeks after history of fall from bed. He was put into a coma state for cerebral protection.Contrast CT imaging revealed ruptured left frontal cerebral abscess with ventriculitis, acute hydrocephalus and cerebral edema. Clinical presentation of an intracranial abscess following trauma may vary such in this case the patient had persistent fever despite on antibiotic which further complicated with status epilepticus. Neurosurgical team planned for drainage but subdued by parents decision which opted for conservative management.

DISCUSSION

This case highlights the necessity for thorough history taking and high index of suspicion as manifestation of brain abscess tend to be nonspecific with fever accounting for 45%-53% and seizures 25%-35% respectively contributing to delay in diagnosis. A high index of suspicion should be maintained , and early imaging such as computed tomography should be considered for patient with symptoms of intracranial infection or who are at high risk, even after a minor head injury. The management of intracranial abscess in the setting of TBI requires a multimodal approach including surgical intervention, antimicrobial therapy and supportive care.

CONCLUSION

In conclusion, early detection and diagnosis, appropriate antibiotic therapy based on knowledge of the causative microbes and surgery are the major prognostic factors for brain abscess. Successful treatment necessitates an integrated approach with a systemic perspective to diagnosis and treatment, involving collaborative effort from various healthcare professionals.