Brain Abscess Rupturing Into The Ventricle

A 64-year-old man was transferred to our hospital with high fever and headache after treated in the local hospital for 50 days. Cerebrospinal fluid (CSF) test revealed methicillin-resistant staphylococcus aureus (MRSA) infection in local institution. Magnetic resonance (MR) imaging showed a cyst on left temporal lobe. With continuous antibacterial therapy, the intrinsic symptoms fell away, but he was lethargic with right hemiplegia and quickly fell into superficial coma. And MR image showed the lesion communicated with left ventricle. We performed decompressive craniotomy with intraventricular drainage and excised the abscess. The patient successfully discharged 2 weeks after operation and computed tomography (CT) scan showed total abscess resection. Such a brain abscess rupturing into ventricle was rare, typical and could be fatal as a result of ventriculitis. We suggest an early surgery after mature abscess wall was formed.