Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 3
Co-Occurrence of Gemistocytic Astrocytoma, Nocardia Brain Abscess and Intracerebral Hematoma in the Same Patient
Erkin SÖNMEZ1, Salih GÜLŞEN1, Cem YILMAZ1, Nur ALTINÖRS1, Özlem ÖZEN2
1Başkent Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Ankara, Türkiye
2Başkent Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, Ankara, Türkiye
Simultaneous occurrence of diff erent pathologies in the intracranial cavity is a well known entity. No organic relationship exists between these pathologies and they are mostly diagnosed incidentally. However, diff erent pathologies can arise as diff erent manifestations of a common pathology. Treatment of three diff erent pathologies in the same patient is very rare and can also be very challenging. The authors report a young male patient, with the diagnoses of glial tumor, nocardia abscess and intracerebral hematoma, who had been operated for acute brain herniation at diff erent times. The patient underwent two surgeries and two mass lesions were excised with the pathological diagnoses of nocardia abscess and grade II gemistocytic astrocytoma, respectively. Appropriate antibiotic treatment and radiotherapy was started. A cranial magnetic resonance imaging performed upon deterioration of the patient during radiotherapy showed a hematoma localized in the right hemisphere between the two surgical sites. Radiotherapy was discontinued and then restarted with completion of the scheduled dose after improvement of the general and neurologic status of the patient. The patient was well seven months after radiotherapy. Anahtar Kelimeler : Cranial radiotherapy, Glial tumor, Intracranial hemorrhage, Nocardia brain abscess