Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Foreword by Sid Gilman
- PART I INTRODUCTION
- PART II THEORIES OF CEREBELLAR CONTROL
- PART III CLINICAL SIGNS AND PATHOPHYSIOLOGICAL CORRELATIONS
- PART IV SPORADIC DISEASES
- 10 Congenital malformations of the cerebellum and posterior fossa
- 11 Multiple system atrophy and idiopathic late-onset cerebellar ataxia
- 12 Corticobasal degeneration
- 13 Cerebellar stroke
- 14 Immune diseases
- 15 Infectious diseases: radiology and treatment of cerebellar abscesses
- 16 Other infectious diseases
- 17 Cerebellar disorders in cancer
- 18 Posterior fossa trauma
- 19 Thyroid hormone and cerebellar development
- 20 Endocrine disorders: clinical aspects
- PART V TOXIC AGENTS
- PART VI ADVANCES IN GRAFTS
- PART VII NEUROPATHOLOGY
- PART VIII DOMINANTLY INHERITED PROGRESSIVE ATAXIAS
- PART IX RECESSIVE ATAXIAS
- Index
15 - Infectious diseases: radiology and treatment of cerebellar abscesses
from PART IV - SPORADIC DISEASES
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Foreword by Sid Gilman
- PART I INTRODUCTION
- PART II THEORIES OF CEREBELLAR CONTROL
- PART III CLINICAL SIGNS AND PATHOPHYSIOLOGICAL CORRELATIONS
- PART IV SPORADIC DISEASES
- 10 Congenital malformations of the cerebellum and posterior fossa
- 11 Multiple system atrophy and idiopathic late-onset cerebellar ataxia
- 12 Corticobasal degeneration
- 13 Cerebellar stroke
- 14 Immune diseases
- 15 Infectious diseases: radiology and treatment of cerebellar abscesses
- 16 Other infectious diseases
- 17 Cerebellar disorders in cancer
- 18 Posterior fossa trauma
- 19 Thyroid hormone and cerebellar development
- 20 Endocrine disorders: clinical aspects
- PART V TOXIC AGENTS
- PART VI ADVANCES IN GRAFTS
- PART VII NEUROPATHOLOGY
- PART VIII DOMINANTLY INHERITED PROGRESSIVE ATAXIAS
- PART IX RECESSIVE ATAXIAS
- Index
Summary
Introduction
The first case of a surgically treated cerebellar abscess was in 1887, by Schwartze (Braun, 1890). However, Charles Ballance was the first neurosurgeon to treat a cerebellar abscess diagnosed by cerebellar findings (Ballance, 1908, 1927). Even though the majority of brain abscesses occur in the supratentorial compartment, many do present in the cerebellum, especially as a complication of otogenic infections. Cerebellar abscess can occur at any age, but the incidence is higher in children between the ages of three and eight and in young adults, with a peak incidence between the second and third decade. It is estimated that 8–18% of purulent brain abscesses are located in the cerebellum (Beller et al., 1973 Gilman et al., 1981).
Much of what we know about the treatment of cerebellar abscesses is generalized from treatment protocols developed for the management of supratentorial abscesses. The difference in management is based on the fact that the posterior fossa is a closed compartment with a small, fixed volume. When a mass lesion presents in the cerebellum, the pressure on surrounding structures can result in fourth ventricular compression, obstructive hydrocephalus, brainstem compression, and tonsillar herniation. Cerebellar abscesses thus require immediate attention, and at times urgent surgical intervention. This chapter focuses on the radiologic appearance of a cerebellar abscess, the histology, and the medical and surgical management options available.
Overview
The presentation of patients with cerebellar abscess is relatively consistent. Briefly, the majority of patients present after experiencing an otogenic infection (Pennybacker, 1948 Nager, 1967 Morgan and Wood, 1975 Shaw and Russell, 1975 van Dellen et al., 1987 Brydon and Hardwidge, 1994 Kurien et al., 1998).
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- Information
- The Cerebellum and its Disorders , pp. 237 - 247Publisher: Cambridge University PressPrint publication year: 2001