{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T18:21:56Z","timestamp":1782498116697,"version":"3.54.5"},"reference-count":41,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Brainstem located abscesses are rare in the pediatric population. Diagnosis of brain abscess can be challenging as patients may present with nonspecific symptoms and the classical triad of headache, fever, and focal neurological deficit is not always present. Treatment can be conservative or a combination of surgical intervention with antimicrobial therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>We present the first case of a 4.5-year-old girl with acute lymphoblastic leukemia that developed infective endocarditis (IE) and subsequently developed 3 suppurative collections (frontal, temporal, and brainstem). The patient had negative cerebrospinal, blood, and pus culture growth and subsequently underwent burr-hole drainage of the frontal and temporal abscesses with a 6-week course of intravenous antibiotic therapy with an uneventful postoperative course. At 1 year, the patient is left with minor right lower limb hemiplegia and no cognitive sequelae.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>The decision to surgically intervene for brainstem abscesses is dependent on surgeon and patient factors including the presence of multiple collections, midline shift, the aim of source identification in sterile cultures, and the patient\u2019s neurological condition. Patients with hematological malignancies should be monitored closely for IE which is a risk factor for hematogenous spread of brainstem located abscesses.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_249_2023","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T03:03:56Z","timestamp":1687403036000},"page":"209","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiple Abscesses in the Frontal, Temporal and Brainstem regions in a 4.5-year-Old Girl- An Illustrative Case Report"],"prefix":"10.25259","volume":"14","author":[{"given":"Retaj","family":"Mohammad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darach","family":"Crimmins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"10.25259\/SNI_249_2023\/ref-1","doi-asserted-by":"crossref","first-page":"2919","DOI":"10.1007\/s00381-020-04835-9","article-title":"Clinical features, microbiology, and management of pediatric brainstem abscess","volume":"36","author":"Antkowiak","year":"2020","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_249_2023\/ref-2","doi-asserted-by":"crossref","first-page":"E483","DOI":"10.1227\/NEU.0b013e318218cf37","article-title":"Abscess of the medulla oblongata in a toddler: Case report and technical considerations based on magnetic resonance imaging tractography","volume":"69","author":"Arzoglou","year":"2011","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_249_2023\/ref-3","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/BF02758560","article-title":"Brain abscess in children","volume":"73","author":"Atiq","year":"2006","journal-title":"Indian J Pediatr"},{"key":"10.25259\/SNI_249_2023\/ref-4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.cmi.2019.05.016","article-title":"Incidence and mortality of brain abscess in Denmark: A nationwide population-based study","volume":"26","author":"Bodilsen","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"10.25259\/SNI_249_2023\/ref-5","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1212\/WNL.0000000000000172","article-title":"Clinical characteristics and outcome of brain abscess: Systematic review and meta-analysis","volume":"82","author":"Brouwer","year":"2014","journal-title":"Neurology"},{"key":"10.25259\/SNI_249_2023\/ref-6","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1056\/NEJMra1301635","article-title":"Brain abscess","volume":"371","author":"Brouwer","year":"2014","journal-title":"N Engl J Med"},{"key":"10.25259\/SNI_249_2023\/ref-7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/QCO.0000000000000334","article-title":"Epidemiology, diagnosis, and treatment of brain abscesses","volume":"30","author":"Brouwer","year":"2017","journal-title":"Curr Opin Infect Dis"},{"key":"10.25259\/SNI_249_2023\/ref-8","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3171\/jns.1974.40.3.0391","article-title":"Brain-stem abscess in childhood. 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