{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:06:46Z","timestamp":1784887606862,"version":"3.55.0"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Intraventricular rupture of brain abscess (IVROBA) remains one of the most devastating complications of bacterial brain abscess, historically associated with high mortality rates. Early identification of measurable predictors of rupture is essential for timely intervention and improved prognosis.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We analyzed a combined retrospective\u2013prospective cohort of 104 patients treated for brain abscesses at two tertiary Moscow hospitals (2018\u20132023). Demographic, clinical, and radiological variables were assessed. Microbiological profiles, management strategies, and outcomes were evaluated. Logistic regression and receiver operating characteristic (ROC) analyses determined predictors of IVROBA and unfavorable outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n IVROBA occurred in 28 patients (26.9%), representing the strongest independent predictor of mortality (adjusted odds ratio [aOR] = 14.2,\n p<\/jats:italic>\n < 0.001) and poor outcome (Glasgow outcome scale 1\u20134). Multivariate analysis confirmed minimal distance between the abscess capsule and the ventricular wall as the predominant risk factor. Abscesses within 0\u20132 mm, 2\u20135 mm, and 5\u201310 mm of the ventricles had progressively higher adjusted odds of rupture (aOR = 87.2, 48.6, and 8.1, respectively; all\n p<\/jats:italic>\n < 0.05) compared with those >10 mm away. Immunodeficiency was an additional independent risk factor (aOR = 9.7,\n p<\/jats:italic>\n = 0.049). ROC analysis identified \u22645 mm as the optimal cutoff (area under the curve = 0.872; sensitivity 84.6%, specificity 81.2%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Proximity to the ventricular system is the principal mechanical determinant of intraventricular rupture, surpassing other clinical and radiologic variables. Abscesses within 5 mm of the ventricle should be managed aggressively, favoring early surgical drainage to prevent fatal rupture and ventriculitis.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_451_2026","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:42:16Z","timestamp":1784886136000},"page":"427","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraventricular rupture of brain abscess: A two-center observational cohort study"],"prefix":"10.25259","volume":"17","author":[{"given":"Dimitri T. K.","family":"Ndandja","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Neurological Sciences, People\u2019s Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennady E.","family":"Chmutin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neurological Sciences, People\u2019s Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Musa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, City Clinical Hospital 68 named after Demihov, Moscow, Russian Federation."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurological Diseases and Neurosurgery, Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignatius N.","family":"Esene","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Nikolenko","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renat","family":"Nurmukhametov","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neurological Sciences, People\u2019s Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Castillo","family":"Rangel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Instituto Polit\u00e9cnico Nacional, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gervith Reyes","family":"Soto","sequence":"additional","affiliation":[{"name":"Department of Neuro oncology, INCAN, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Montemurro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Via Roma, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel De Jesus Encarnacion","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Peoples Friendship University of Russia, Assistant of the Department of Human Anatomy and Histology of the Institute of Clinical Medicine named after N.V. Sklifosovskiy, Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"10.25259\/SNI_451_2026\/ref-1","first-page":"31","article-title":"Factors influencing the outcomes and mortality of brain abscess: A retrospective analysis of 54 cases","volume":"18","author":"Ahn","year":"2022","journal-title":"J Korean Ster Func Neurosurg"},{"key":"10.25259\/SNI_451_2026\/ref-2","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1093\/brain\/awac312","article-title":"Clinical features and prognostic factors in adults with brain abscess","volume":"146","author":"Bodilsen","year":"2023","journal-title":"Brain A J Neurol"},{"key":"10.25259\/SNI_451_2026\/ref-3","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s11739-016-1564-x","article-title":"Precipitous neurologic decline following intraventricular rupture of a cerebral abscess: Classic imaging findings in ventriculitis and pyocephalus","volume":"12","author":"Cox","year":"2017","journal-title":"Intern Emerg Med"},{"key":"10.25259\/SNI_451_2026\/ref-4","doi-asserted-by":"crossref","first-page":"396","DOI":"10.4103\/1793-5482.185065","article-title":"Good outcomes with the intraventricular vancomycin therapy in a patient with ruptured brain abscesses","volume":"13","author":"Doan","year":"2018","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_451_2026\/ref-5","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/CM9.0000000000001203","article-title":"A report on pneumonia-induced ventriculitis with intraventricular abscess","volume":"134","author":"Gui","year":"2020","journal-title":"Chin Med J (Engl)"},{"key":"10.25259\/SNI_451_2026\/ref-6","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s42399-025-01933-0","article-title":"Cerebral aspergilloma mimicking brain tumor as challenge for neurocritical care medicine: A case report","volume":"7","author":"Janjua","year":"2025","journal-title":"SN Compr Clin Med"},{"issue":"3","key":"10.25259\/SNI_451_2026\/ref-7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1136\/jnnp.2006.097808","article-title":"Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses","volume":"78","author":"Lee","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/SNI_451_2026\/ref-8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1159\/000505233","article-title":"Postoperative textiloma mimicking intracranial rebleeding in a patient with spontaneous hemorrhage: Case report and review of the literature","volume":"12","author":"Montemurro","year":"2020","journal-title":"Case Rep Neurol"},{"key":"10.25259\/SNI_451_2026\/ref-9","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.3390\/app11083316","article-title":"Multiple brain abscesses of odontogenic origin. 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