Neuropathological and computerized tomographic findings in experimental brain abscess
- 1 October 1981
- journal article
- research article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 55 (4), 590-603
- https://doi.org/10.3171/jns.1981.55.4.0590
Abstract
✓ The neuropathological progression of brain abscess formation was studied experimentally at sequential stages in dogs, and the findings correlated with the appearance on computerized tomographic (CT) brain scans. The evolution of brain-abscess formation was divided into four stages based on histological criteria: early cerebritis (Days 1 to 3); late cerebritis (Days 4 to 9); early capsule (Days 10 to 13); and late capsule formation (Day 14 and later). The cerebritis stage was characterized by prominent perivascular cuffing by inflammatory cells in the area adjacent to the developing necrotic center. However, the early elements of capsule formation appeared with the presence of fibroblasts by Day 5. The CT scans showed ring-shaped contrast enhancement by Day 3. Delayed scans at 30 minutes revealed diffusion of the contrast material into the developing necrotic center, forming a solid lesion. In lesions that were well encapsulated (14 days and older), five distinct histological zones were apparent: 1) a well formed necrotic center; 2) a peripheral zone of inflammatory cells, macrophages, and fibroblasts; 3) the dense collagenous capsule; 4) a layer of neovascularity associated with continuing cerebritis; and 5) reactive astrocytes, gliosis, and cerebral edema external to the capsule. The CT appearance of well encapsulated abscesses showed a typical ring-shaped contrast-enhancing lesion. On delayed scans, the “ring” did not fill in with contrast enhancement. The diameter of the ring correlated best with the presence of cerebritis (perivascular infiltrates in the adventitial sheaths of vessels surrounding the abscess). The discussion focuses on the relevance of this study to the current management of patients with brain abscess.This publication has 70 references indexed in Scilit:
- CT-Befunde bei HirnabszessenRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 1979
- The Biosynthesis of Collagen and Its DisordersNew England Journal of Medicine, 1979
- Nonsurgical cure of brain abscess: Early diagnosis and follow‐up with computerized tomographyAnnals of Neurology, 1978
- Ultrastructural distinction between reticular and collagenous fibers with an ammoniacal silver stainThe Anatomical Record, 1977
- Brain abscess and subdural empyema. Factors influencing mortality and results of various surgical techniques.Journal of Neurology, Neurosurgery & Psychiatry, 1976
- The EMI scanner. A brief review of the first 650 patientsThe British Journal of Radiology, 1974
- Surgical treatment of brain abscess and subdural empyemaJournal of Neurosurgery, 1973
- Septic Cerebral EmbolismStroke, 1972
- Nocardial Infection of the Pulmonary and Central Nervous System: successful Treatment with Medical TherapySouthern Medical Journal, 1971
- MORPHOLOGICAL AND CHEMICAL STUDIES OF COLLAGEN FORMATIONThe Journal of cell biology, 1961