A case of thalamic abscess treated by stereotactic aspiration in a pediatric patient: case report

Abstract Background The incidence of intracerebral abscess is considered to be around 8% of all the intracranial lesions. In pediatric patients, intracranial abscess lesions localized in the deep gray matter structures, such as basal ganglia and thalamus, are not frequently seen. Despite being potentially curable, they still carry a high level of mortality and morbidity. The 5% mortality rate is mainly due to brain herniation or abscess rupture into ventricles. Case description Here, we describe a case of a 12-year-old male patient, who presented with headache. Cranial MRI with contrast enhancement revealed a space-occupying lesion measuring 37 × 35 × 26 mm in its maximum diameter in the region of the left thalamus, with marked ring enhancement, perilesional edema, compression of the third ventricle and a 5 mm midline shift. The MRI findings were consistent with an intracerebral abscess. A stereotactic aspiration using the Leksell Frame was performed. Conclusion In the last three decades, there is a major improvement in the management of intracerebral abscesses. Methods like stereotactic aspiration, stereo-endoscopic aspiration and ultrasound-guided aspiration are minimally invasive, carry low morbidity allowing to be performed on compromised patients via local anesthesia.