Management of Brain Abscess Study of 45 Cases
Keywords:
Brain Abscess, CT brain, Bur hole aspirationAbstract
Objective: To evaluate the signs and symptoms, to diagnose the abscess early and to provide rational treatment and minimize the complications.
Results: In this study included 45 patients 32 (71.1%) were male and 13 (28.9%) female. In this study analysed the results of different surgical procedures performed in brain abscess and combined therapy. The male and female ratio was 2.5:1 and high incidence was found in young patients mainly in first two decades of life. Otitis media 14 (31.1%) and congenital heart diseases 12 (26.7%) were the commonest causes of cerebral abscesses. Headache (51%), vomiting (51%), fever (53%) and neurological deficits (22.2%) were important signs and symptoms. Computer Tomography Scan (CT) was the common radiological investigation. The most frequently involved sites were temporal lobe in cases 14 (31.1%), frontal in 11 (24.4%) and cerebellum in 10 (22.2%) patients. In 82.2% of cases the volume of pus aspirated was less than 100ml. In 35 (77.8%) cases the first choice of treatment was bur hole aspiration. The excellent outcome was found in 80% of cases.
Conclusions: The cerebritis stage of abscess formation needs rational use of antibiotics, complete abscess with cavity needs bur hole aspiration. Brain abscesses with retained foreign body, CSF leak, containing air and fungal abscess should be excised. Cerebeller abscesses needs early evacuation or excision. Abscesses larger than 3 cm needs drainage and smaller than 1,7cm can be treated conservatively.
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