ORIGINAL ARTICLES A Fatal Case of a Huge Brain Abscess Misdiagnosed as Migraine Headache in an 18-Year-Old Woman

West Afr J Med . 2023 May 27;40(5):565-567.

Abstract

Abstract  in English, French

Background: Mortality associated with delayed diagnosis of brain abscess is high. A high index of suspicion in conjunction with the use of neuroimaging is important for the early diagnosis of brain abscess. Early use of appropriate antimicrobial and neurosurgical care improves outcomes.

Methods: We report a fatal case of an 18 year old female with a huge brain abscess who was misdiagnosed as a case of migraine headache over a 4-month period in a referral hospital.

Report: An 18-year-old female with a missed history of recent furuncles occurring in the right frontal part of her head and right upper eyelid who presented with a recurrent throbbing headache to a private hospital over 4 months. There was a positive maternal history of episodic headaches, as such, the patient was diagnosed as having a migraine headache disorder at the private hospital. The patient was referred to our facility on account of repeated seizures over 2 days and lapsing into a coma. Clinical examination showed evidence of focal neurologic deficits and a suspicion of brain abscess was confirmed with an urgent cranial MRI. She succumbed to her illness within 3hrs of presentation.

Conclusion: Detailed history, a high index of suspicion, use of appropriate neuroimaging and early diagnosis is important in reducing the mortality associated with brain abscess.

Keywords: Brain abscess; Migraine headache; Primary headache; Seondary headache.

C M Opeyemi ¹, F T Akinlade ²