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Brain Abscess

Hi there.

Can you answer this question for me please?

My sister has a brain abscess that originally was located in the center of the brain and she developed spinal meningitis. A week ago, the CAT scan showed the abscess had moved to the "right ventricle". The doctors are puzzled about the bacteria and are unable to find out what the bacteria is and have sent something from Alberta Canada to Toronto ON to find out what it might be. The results are not back yet from Toronto. Now the doctors are talking about doing surgery to take out the abscess and do a biopsy but not for a while yet.

My questions are:

1. What is the material that was sent to Toronto?
2. The material that was sent to Toronto, is that the same material as what the biopsy would be; in other words, the stuff that was sent to Toronto, would that not have been a withdrawal of fluid or whatever to do a biopsy so why would it warrant another biopsy if they take out the abscess?
3. Why have they not done surgery yet, either when the abscess was in the center of the brain and now in the right ventricle?
4. What and where is the right ventricle of the brain? Is there a picture somewhere?
5. If surgery is performed, is this serious enough that it would warrant that I go to be with my sister in case something goes wrong?
6. What could go wrong if she goes in for surgery?
7. Is there anything else that you can tell me about this condition??
8. Could it be the spinal fluid they sent to Toronto?

Answers:

Hi, thanks for your question. Here's the link to my answer:

http://askdoctorjoshua.com/2007/02/1...brain-surgery/

Please keep us posted and feel free to ask more questions here. Best wishes to your sister.Hi Dr. Joshua,

I have a couple more questions regarding my sister.

It has been 6 weeks now (from 14 Jan) since my sister was diagnosed with the brain abscess. Today she has had another appointment with her neurosurgeon but was so out of it that she couldn't ask questions. The CT Scan that she recently had is showing that the abscess, even though it had moved into the right ventricle behind the eyeball, has not decreased.

Currently she is on 20 mg prednisone, Apo-Metronidazole, 500 mg 3 TID (3 times a day) and what we think is "Cefotaxime" - an IV/Saline solution which takes about 1/2 hr to finish.

Her doctor has told her that they are going to continue the course of treatment until the end of March at least. The Prednisone is also being tapered off. Her headaches are not as severe as when she was admitted to hospital but they do hurt. My sister is wondering if there is something else that can be done to try to speed up her recovery and avoid surgery?

Thanks very much.

YvonneThanks for the update, Yvonne. I'm sure her doctors are doing everything they can to ensure as speedy a recovery as possible. I'm not in the position to give treatment suggestions, but I do wish her all the best, and you are welcome to ask more questions here if you think we may be able to help you understand the situation.Hi. Can you please e-mail me at ivycarlos@yahoo.com. My mom had a brain abscess and you are the very first person that I have found who knows someone who has a similar problem.

Thank you.I also have a question about a brain abscess.

My husband had an epileptic fit in November and was diagnosed with 2 brain abscesses. A biopsy was done on the superficial one and it was drained. The second (about 18mm) was treated with a combination of antibiotics. There was a little sidetrack, as he also had two PEs from the PICC line, but once that was diagnosed and treated he has recovered quite well. The smaller abscess has totally gone and the one being treated by antibiotics only is now well on the way to disappearing.

My husband has been on Dilantin since November, but now it is getting closer to the time when he might be able to get off it.

He has had no further fits. He initially had a huge amount of edema, but that seems gone, except for a small amount around the abscess. Initially he had weakness on one side but that cleared up fairly quickly. He still gets quite tired and is a bit slow - he can still do quite complicated logic, but just at a very slow pace.

My question is related to the tapering off of the Dilantin. How often are people successful in getting off anti-convulsants? How likely is he to have long term fits and have to be on Dilantin permanently? Are there any predicators of whether he is likely to fit or not after coming off Dilantin? He will be seeing a neurologist in about 6 weeks, but I would be grateful for any information/statistics on this subject.

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Brain Abscess

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