Affiliations: Departments of Neurosurgery, Sanjay Gandhi
Postgraduate Institute of Medical Sciences and C.S.M. Medical University,
Lucknow, India | Departments of Neuroanaesthesiology, Sanjay Gandhi
Postgraduate Institute of Medical Sciences and C.S.M. Medical University,
Lucknow, India
Note: [] Correspondence: Dr. Raj Kumar, Associate Professor Department of
Neurosurgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow
- 226014, U.P. INDIA. Tel: 0 522-2668700, fax: 91 (522) 2668129. E-mail:
[email protected]
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
IV^{th} 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).
