doiSerbia

Focal brain lesions as a consequence of an obscure neurosurgical treatment in drug-addicted patient

Stojić Ivana (Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia)
Ilić Dalibor (Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia)
Juković Mirela (Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia)
Vujanović Miloš (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Clinic for Infectious Diseases, Novi Sad, Serbia)
Čanak Ivana (Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia)
Till Viktor (Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia)

Introduction. Infectious or non-infectious noxae may occur in drug-addicted patients who have clinical presentation of meningeal syndrome with a spectrum of possible complications, such as a diffuse or focal brain lesions. The objective of this report is to present a rare case of a drug-addicted male patient, initially suspected of mycosis of the central nervous system, but computed tomography (CT) and magnetic resonance imaging (MRI) showed the signs of an invasive neurosurgical operation that the patient underwent during the treatment of drug addiction. Case outline. A 37-year-old male patient was hospitalized at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, with a meningeal syndrome, initially suspected of mycosis of the central nervous system. He was diagnosed at the Center for Radiology. Neuroimaging – CT and MRI were used in order to prove or disprove the presence of brain infection. These diagnostic procedures ruled out the presence of brain infection, but opened questions about the type of neurosurgical treatment performed out of legal institution, due to the presence of craniotomy and focal glial brain lesions in the frontal lobes. Conclusion. In drug-addicted patients, meningeal syndrome can be connected with diffuse or focal brain infections. Together with laboratory and clinical analysis, imaging methods contribute to the decision making and optimal treatment of patients. In our case, CT and MRI made a significant contribution in the detection of the focal brain lesions and clarification of their etiology.

Keywords: magnetic resonance imaging, tomography, X-ray computed, substance-related disorders, neuroimaging, craniotomy, nervous system