Presentamos el caso de un paciente de 61 años, quien tras tres semanas de una rinitis alérgica, desarrolla un cuadro neurológico agudo de afectación bulbar y vías largas
El cuadro clínico neurológico y la resonancia nuclear magnética dieron el diagnóstico de presunción. La paciente fue intervenida de urgencia mediante una craniectomía suboccipital y acceso microquirúrgico. Se aspiró un contenido purulento de una cavidad quística alargada que se extendía desde el bulbo a la unión bulbo medular. La evolución fue muy favorable y la enferma fue dada de alta con un pequeño déficit del nervio glosofaríngeo derecho que está recuperando paulatinamente. Se revisa la bibliografia y se discuten las distintas opciones terapéuticas.
A case of solitary brain stem abscess in a 61-year old woman is presented. The clinical picture and the magnetic resonance imaging allowed the presumptive diagnosis to be made. The abscess was located in the medullar pars of the brain stem and was aspirated using a infratentorial approach. The patient was discharged with only a mild glosofaringeal nerve deficit as a residual signo Early accurate diagnosis and appropriate surgical management are especially important for successful treatment of this potentially fatal condition.
The literature is reviewed, and the role of microsurgical approach, stereotaxy or medical treatment is discussed.
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