A case of cerebral putaminal hemorrhage complicating a brain abscess proved by craniotomy

A 40-year-old man was admitted to our hospital because of consciousness disturbance, dysarthria and numbness in his right hand. Computed tomography of the head showed a cerebral hemorrhage of the left putamen. The patient was judged to have an indication of operation, and frontal craniotomy to evacuate hematoma was performed. During the operation, massive whitish pus flowed out at the time of surgery. Therefore, hemorrhage into a brain abscess was diagnosed. We reported this unique and interesting case whose brain abscess could not be differentiated from an ordinary hypertensive putaminal hemorrhage based on clinical findings and CT image. This diagnosis was not made until the patient was operated on through a craniotomy.