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Journal of Pediatric Neurology 2004; 02(02): 101-106
DOI: 10.1055/s-0035-1557201
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Tuberculous brain stem abscesses in children

Raj Kumar
1   Departments of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences and C.S.M. Medical University, Lucknow, India
,
Vinita Singhi
2   Departments of Neuroanaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences and C.S.M. Medical University, Lucknow, India
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Further Information

Publication History

30 December 2003

21 January 2004

Publication Date:
29 July 2015 (online)

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Abstract

Tuberculous brain stem abscess is a highly uncommon entity. Three children with tuberculous brain stem abscesses of 1 month, 7 and 12 years of age were treated by microsurgical evacuation and biopsy of capsule, utilizing safe incisions over dorsal brain stem, through the floor of IVth ventricle. There was no added deficit postoperatively in these children. Microsurgical evacuation and biopsy helped in differentiating these lesions from pyogenic abscesses in two cases for appropriate treatment. The third operated case was a child, who while being on antituberculosis treatment for proven tuberculous meningitis for 1.5 year developed medullary and pontine abscess and tuberculoma exemplifying a paradoxical response to chemotherapy. Brain stem abscess especially tuberculous need surgical drainage, as it provides an accurate proof of offending organism and also takes care of a paradoxical response to antituberculosis chemotherapy in diagnosed cases. The safe incisions on brain stem are helpful to avoid the morbidity. (J Pediatr Neurol 2004; 2(2): 101–106).

Keywords

brain stem abscess - tuberculosis