Brainstem abscess of undetermined origin: microsurgical drainage and brief antibiotic therapy

CONTEXTO:Abscessos isolados do tronco encefálico são raros e geralmente associados a outras infecções. Trata-se de condição grave, com grande morbidade e mortalidade. Opções cirúrgicas são aspiração com estereotaxia e drenagem microcirúrgica. Antibioticoterapia sistêmica tem sido usada por mais de seis semanas.RELATO DE CASO:Apresentamos o caso de um jovem com abscesso pontino sem outras infecções sistêmicas. O paciente foi tratado com drenagem microcirúrgica e antibioticoterapia por três semanas. Houve boa evolução pós-operatória.CONCLUSÕES:Acesso microcirúrgico pode ser considerado uma opção importante no tratamento de grandes abscessos do tronco encefálico, que são multiloculados, próximos da superfície ou que contenham líquido espesso. Drenagem completa do material purulento pode diminuir o período de antibioticoterapia.CONTEXT:Solitary brainstem abscesses are rare and they are usually associated with other infections. They are severe conditions with high morbidity and mortality. The surgical options are stereotactic aspiration and microsurgical drainage. Systemic antibiotic therapy is used for more than six weeks.CASE REPORT:We present the case of a young man with a solitary abscess at the pons, without other systemic infections. The patient was treated by means of microsurgical drainage and antibiotic therapy for three weeks. His postoperative recovery was good.CONCLUSIONS:A microsurgical approach may be considered to be an important option for large abscesses that are multiloculated, close to the surface or contain thick fluid. Complete emptying of the purulent accumulation may diminish the required duration of antibiotic therapy.Universidade Estadual Paulista Faculdade de Medicina de Botucatu Department of Neurology, Psychology and PsychiatryUniversidade Estadual Paulista Faculdade de Medicina de Botucatu Department of Neurology, Psychology and Psychiatr

Revival of the Magnetar PSR J1622–4950: Observations with MeerKAT, Parkes, XMM-Newton, Swift, Chandra, and NuSTAR

© 2018. The American Astronomical Society.. New radio (MeerKAT and Parkes) and X-ray (XMM-Newton, Swift, Chandra, and NuSTAR) observations of PSR J1622-4950 indicate that the magnetar, in a quiescent state since at least early 2015, reactivated between 2017 March 19 and April 5. The radio flux density, while variable, is approximately 100 larger than during its dormant state. The X-ray flux one month after reactivation was at least 800 larger than during quiescence, and has been decaying exponentially on a 111 19 day timescale. This high-flux state, together with a radio-derived rotational ephemeris, enabled for the first time the detection of X-ray pulsations for this magnetar. At 5%, the 0.3-6 keV pulsed fraction is comparable to the smallest observed for magnetars. The overall pulsar geometry inferred from polarized radio emission appears to be broadly consistent with that determined 6-8 years earlier. However, rotating vector model fits suggest that we are now seeing radio emission from a different location in the magnetosphere than previously. This indicates a novel way in which radio emission from magnetars can differ from that of ordinary pulsars. The torque on the neutron star is varying rapidly and unsteadily, as is common for magnetars following outburst, having changed by a factor of 7 within six months of reactivation