Brain Abscess Causes Brain Damage With Long-Lasting Focal Cerebral Hypoactivity that Correlates With Abscess Size: A Cross-Sectional 18F-Fluoro-Deoxyglucose Positron Emission Tomography Study.

Autor:	Müller EG; Division of Radiology and Nuclear Medicine, Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Dahlberg D; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway., Hassel B; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Norwegian Defence Research Establishment (FFI), Kjeller, Norway.; Department of Neurohabilitation and Complex Neurology, Oslo University Hospital, Oslo, Norway., Revheim ME; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Division of Technology and Innovation, The Intervention Centre, Oslo University Hospital, Oslo, Norway., Connelly JP; Division of Radiology and Nuclear Medicine, Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2024 Nov 11. Date of Electronic Publication: 2024 Nov 11.
DOI:	10.1227/neu.0000000000003268
Abstrakt:	Background and Objectives: Bacterial brain abscesses may have long-term clinical consequences, eg, mental fatigue or epilepsy, but long-term structural consequences to the brain remain underexplored. We asked if brain abscesses damage brain activity long term, if the extent of such damage depends on the size of the abscess, and if the abscess capsule, which is often left in place during neurosurgery, remains a site of inflammation, which could explain long-lasting symptoms in patients with brain abscess. Methods: 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT), electroencephalography, and MRI were performed 2 days to 9 years after neurosurgery for bacterial brain abscess. Results: FDG-PET/CT revealed hypometabolism in the neocortex or cerebellum overlying the previous bacterial abscess in 38 of 40 patients. The larger the abscess, the greater was the extent of the subsequent hypometabolism (r = 0.63; p = 3 × 10-5). In 9 patients, the extent of subsequent hypometabolism seemed to coincide with the extent of peri-abscess edema in the acute phase. Follow-up MRI after ≥1 year in 9 patients showed focal tissue loss and gliosis. In 13 patients with abnormal electroencephalography recordings, abnormalities extended beyond the cerebral lobe affected by the abscess, indicating damage to wider brain networks. The abscess capsule had an FDG signal indicating inflammation only during the first week after neurosurgical pus drainage. Conclusion: The bigger a brain abscess is allowed to grow, the more extensive is the long-term focal reduction in brain activity. This finding emphasizes the need for rapid neurosurgical intervention. The abscess capsule does not display long-lasting inflammation and probably does not explain long-term symptoms after brain abscess. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.)
Databáze:	MEDLINE
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