RESUMO
CT guided stereotaxic biopsy (aspiration) has been proved as a procedure of choice in the assessment and treatment of a deep-seated sinusogenic, brain abscess in a 54-year old man. The clinical features were atypical; massive neurological deficits (left-side spastic hemiplegia, dysarthria, urinary incontinence) without signs and symptoms of infectious disease. The clinical course and CT finding primarily showed a metastatic neoplastic process surrounded by a large edema in the right fronto-parietal parts so that an abscess or less probably glioma were also considered. From the neurosurgeon's point of view the process was inoperable because of the localization and unknown etiology. Due to recent studies, CT-guided stereotaxic biopsy confirmed the diagnosis of the brain abscess, even when the pus was evacuated by aspiration. CT-guided stereotaxic aspiration together with anti-edematose and target antibiotic therapy, has made possible impressive, complete recovery within ten days. It has been achieved by intravenous administration of Penicillin G (24 million UI per day) during 3 months. The control CT findings and the following clinical course confirmed the resolution of the abscess. The aim was to show a case of a successfully treated brain abscess with CT- guided stereotaxic biopsy (aspiration) and to present great advantages of this method primarily as a safe and effective technique which makes possible minimal traumatization of a patient and fast recovery with minimal risk of invalidity.
