A new report highlights successful robot-guided single-session drainage of multiple deep brain abscesses while minimising surgical trauma.
Brain abscesses are among the most serious infections encountered in neurosurgery. When multiple abscesses develop deep inside the brain, they can cause severe swelling, dangerous pressure on surrounding tissue, and rapid neurological deterioration.
Conventional treatment often combines antibiotics with surgical drainage, but patients with widespread or bilateral lesions may require multiple procedures or extensive open surgery, increasing the risk of complications and delaying infection control.
Addressing this challenge, a research team led by Professor Jun Wang from the Department of Neurosurgery at the First Hospital of China Medical University, China, used robot-assisted stereotactic surgery as a minimally invasive strategy to treat an unusually complex case involving multiple deep brain abscesses.
They reported the successful treatment of a 21-year-old woman with six deep brain abscesses using a single session of robot-guided stereotactic aspiration. This paper was published in Volume 12 of the Chinese Neurosurgical Journal.
The patient arrived with a seven-day history of fever, headache, vomiting, and progressive deterioration in consciousness after treatment elsewhere for a suspected respiratory infection.
Brain magnetic resonance imaging (MRI) revealed six ring-enhancing abscesses involving both frontal lobes and the right temporal and occipital lobes.
The largest lesion measured 3.9 × 3.3cm, and all the abscesses were associated with severe oedema and a significant midline shift, indicating a high risk of life-threatening brain herniation, making urgent surgical intervention necessary.
The team used a robot-assisted stereotactic navigation system. Preoperative MRI and intraoperative computed tomography images were fused to create a detailed 3D model of the brain.
Surgeons planned four safe trajectories to reach the six abscess cavities while avoiding critical blood vessels, functional brain regions, and the ventricles. Notably, two of these trajectories enabled surgeons to access two abscesses each through a shared entry path, reducing the number of cortical entry points and potentially minimising surgical trauma.
Professor Wang said: ‘This case highlights the advantages of precision minimally invasive multi-target surgery together with an evidence-based perioperative pharmacologic strategy. Robot-assisted stereotactic aspiration may represent a feasible and potentially effective strategy for managing multifocal deep-seated brain abscesses.’
