Cryptogenic Pontine Abscess Treated With Stereotactic Aspiration: A Case Report

Abstract

Brainstem abscesses are localized collections of pus or infected material within the brainstem, which can cause inflammation, tissue damage, and compression of adjacent structures. This can lead to a variety of symptoms, including headache, fever, and focal neurological deficits, among many others. Brainstem abscesses are potentially life-threatening and considered to be rare, and pontine abscesses are even rarer. Both are often caused by the spread of infection from nearby structures like the middle ear, sinuses, and mastoid air cells, but they can also result from distant infectious sites that have spread to the bloodstream. Ambiguous clinical presentation can delay appropriate care and lead to poorer outcomes. We present a rare case of pontine abscess in a 54-year-old male with both undetermined causal origins and unclear infectious signs, namely, the lack of fever, fatigue, and chills. We will discuss the etiologies, diagnosis, and treatment of cryptogenic brainstem lesions in this case report.

Keywords: brain abscess; brainstem abscess; idiopathic brain abscess; pontine abscess; stereotactic needle aspiration.

Figure 1. Contrast-enhanced head MRI showing ring-enhancing lesion in right pons (yellow arrow) in both axial (A) and coronal (B) views.

Figure 2. Postoperative head MRI with T2 fluid-attenuated inversion recovery sequence showing reduced ring-enhancing lesion in right pons (yellow arrow) in both axial (A) and coronal (B) views.