Maladies cardiovasculaires et diagnostic

Brain Abscess in Uncorrected Tetralogy of Fallot Diagnosed during Preparation for Computed Cardiac Angiotomography

Abstract

Valdano Manuel, Ester Matias, Humberto Morais, Gade Miguel, Maria Ana Sampaio Nunes, Adilson de Oliveira, Jorge Manresa and Antonio Pedro Filipe Junior

We describe the case of a 9-year-old boy with uncorrected tetralogy of Fallot who presented with seizures at the computed tomography room during the preparation for cardiac computed tomography angiography in order to characterize the cardiac defect. The cardiac computed tomography angiography was suspended, and a brain computed tomography without contrast was performed followed by brain magnetic resonance imaging. The brain scan showed a large abscess in the right temporo-parietal region with important midline shift. The management of the patient was a combination of antibiotic therapy and osteoplastic craniotomy with removal of abscess capsule. At the discharge the patient looks well and no focal deficits on neurological examination were observed. Now-a-days he is following up with heart surgeons for correction of the tetralogy of Fallot. The aim of this report is highlight the importance of recognizing the brain abscess in patients with uncorrected congenital heart disease. The authors also discuss the better therapeutic option of this serious often fatal complication.