Treatment of a subdural empyema complicated by intracerebral abscess due to Brucella infection

A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE) recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months) that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.

Comparison of the gallbladder damage caused by microwave ablation and cryoablation in vivo porcine livers.

PURPOSE: To compare the imaging, anatomy, and histopathology of the porcine liver tissue adjacent to the gallbladder, as well as the temperature of the gallbladder wall and the damage degree of gallbladder wall at different times after microwave ablation (MWA) and cryoblation. MATERIALS AND METHODS: Sixteen pigs were randomly divided into MWA group (Group M) and cryoblation group (Group C). The pigs were randomly divided into 8 subgroups according to their execution time, with 2 pigs in every subgroup. The pigs were executed immediately after operation, or at 1‑, 2‑, and 4‑weeks postoperatively according to their assigned subgroup. The imaging and anatomy change of the liver ablation zone and the gallbladder wall were recorded. Histopathological observation was carried out for the damage portion of the gallbladder and the adjacent liver parenchyma. RESULTS: (1) There were no significant statistical differences of the damage degree of the gallbladder between the two groups (P = 0.842). (2) Gallbladder wall edema occurred in Group M immediately after ablation (6/8), of which, 3 cases of gallbladder wall reached full‑thickness damage; overlapping of ice ball and gallbladder wall occurred in Group C (5/8), of which, 4 cases of gallbladder wall reached full‑thickness damage. However, there was neither perforation of gallbladder, biliary fistula, nor liver abscess in all cases. CONCLUSION: Both MWA and cryoablation for liver tissues adjacent to the gallbladder could lead to different damage degrees of the gallbladder wall, but not gallbladder perforation even under the condition of full‑thickness damage.