Brain abscesses, located deep in the brain, can quickly become life-threatening and are often difficult to treat with traditional surgery. In a single patient case report, researchers describe how to use robot-guided stereotaxic surgery to drain six intracranial abscesses through four carefully planned trajectories during one surgery. A minimally invasive approach, combined with targeted antimicrobial therapy and controlled edema management, resulted in rapid neurological recovery and full functional recovery with no evidence of recurrence.
Brain abscesses are one of the most serious infections encountered in neurosurgery. When multiple abscesses develop deep in the brain, they can cause severe swelling, dangerous pressure on surrounding tissue, and rapid neurological deterioration. Conventional treatment often combines antibiotics and surgical drainage, but patients with extensive or bilateral disease may require multiple procedures or major open surgery, increasing the risk of complications and delaying infection control.
To address this challenge, a research team led by Professor Wang Jun of the Department of Neurosurgery, First Hospital of China Medical University, used robot-assisted stereotactic surgery as a minimally invasive strategy to treat an unusually complex case with multiple deep brain abscesses. They reported that a 21-year-old woman with six deep brain abscesses was successfully treated with a single session of robot-guided stereotactic aspiration. This paper was published in the journal Volume 12. Chinese Neurosurgical Journal May 27, 2026.
After receiving treatment at another hospital for a suspected respiratory infection, the patient presented with a 7-day history of fever, headache, vomiting, and progressive loss of consciousness. Brain magnetic resonance imaging (MRI) revealed six annularly enhancing abscesses involving both the frontal and right temporal and occipital lobes. The largest lesion was 3.9 × 3.3 cm, and all abscesses were associated with severe edema and significant midline deviation, indicating a high risk of life-threatening brain herniation and requiring urgent surgical intervention.
Instead of performing a traditional craniotomy, the researchers used a robot-assisted stereotactic navigation system. Preoperative MRI images and intraoperative computed tomography images were fused to create a detailed three-dimensional model of the brain. Surgeons planned four safe trajectories to reach the six abscess cavities while avoiding important blood vessels, functional areas of the brain, and ventricles. In particular, two of these trajectories allowed the surgeon to access two abscesses via a shared entry route (“one puncture, two injections”), potentially reducing the number of cortical entry points and minimizing surgical trauma.
Professor Wang explains:This case highlights the benefits of precision minimally invasive multitargeted surgery in conjunction with evidence-based perioperative pharmacological strategies.. ”
During surgery, each abscess cavity was drained and irrigated with gentamicin saline. Broad-spectrum antibiotics were started immediately and then narrowed based on culture and antimicrobial susceptibility testing after laboratory identification. streptococcus intermediate As a causative bacterium. Because of the extensive swelling, the patient also received short-term, closely monitored low-dose dexamethasone to reduce brain edema while minimizing long-term immunosuppression that could interfere with infection control.
The results were encouraging. Fever and meningeal symptoms resolved within 72 hours, consciousness rapidly returned, and MRI 1 month after surgery showed complete resolution of the abscess and almost complete disappearance of the abscess wall. The patient recovered full function with a Karnofsky Performance Status score of 100 and had no recurrence during 6-month and 1-year follow-up examinations.
Professor Wang added:Robot-assisted stereotactic aspiration may be a feasible and effective strategy for managing multifocal deep brain abscesses. ”
Although this report describes a single patient, this case demonstrates the potential of combining robotic-guided stereotactic surgery with multidisciplinary expertise from neurosurgeons, neuroradiologists, infectious disease specialists, and critical care teams to support the management of particularly challenging intracranial infections. In carefully selected patients, this minimally invasive strategy may reduce surgical trauma, allow rapid decompression of multiple abscesses in a single procedure, and promote neurological recovery, but larger clinical studies are needed to confirm these findings.
Overall, this rare case demonstrates how advanced robotic technology, integrated image processing, optimized antimicrobial therapy, and careful edema control can work together to manage highly complex brain infections through a single minimally invasive procedure, providing valuable insight into future emergency neurosurgical care.
sauce:
First Hospital of China Medical University
Reference magazines:
Wei, Y. others. (2026) Robot-guided stereotactic single-stage evacuation for six intracranial abscesses: a rare case report with literature review. Chinese Journal of Neurosurgery. DOI: 10.1186/s41016-026-00436-8. https://link.springer.com/article/10.1186/s41016-026-00436-8
