[Aspiration and drainage for brain abscess causing massive bleeding from abscess capsule: case report]

The authors report a rare complication during aspiration of a brain abscess. A 23 year-old man who had undergone surgery for empyema two months previously presented himself at our hospital complaining of headache, deterioration of activity and conscious level. An emergency computed tomography demonstrated a left frontal brain abscess. Aspiration and drainage were performed. However, this resulted in massive hematoma in and around the abscess capsule. Following craniotomy and excision of the abscess, the patient was cured. Microscopic examination of the abscess revealed the formation of a complete capsule consisting of fibroblasts and collagen fiber. In addition to this, significant neovascularization with inflammatory cells was apparent around the capsule. These findings suggest that profuse hemorrhage may occur in aspiration and drainage surgery.