Clinical Characteristics and Outcome Assessment of Brain Abscess in Children and Adolescents; a 2 Years Neurosurgical Perspective
Background: Brain abscess is a serious infective disorder of the central nervous system with high rates of prolonged morbidity and mortality. Effective neurosurgical management is the key to lower morbidity and death rates due to this disease.
Material and Methods: This study was conducted prospectively at the Department of Neurosurgery, Hayatabad Medical Complex Peshawar from January 2013 to December 2014. Presenting clinical features, radiological characteristics and surgical findings were recorded. Emphasis was placed to test the effectiveness of prompt surgery, good antibiotic coverage and the use of drainage tubes in reducing recurrence rates and lowering mor-bidity and mortality. The patients were followed for one month postoperatively and their functional outcome plus radiological resolution recorded.
Results: 48 cases were included in the study with 33 (68.8%) males and 15 (31.3%) females and mean age of 9.7 years (SD ± 4.5). Median GCS on presentation was 12 (SD ± 3.1) and mean diameter of the abscess cavity was 4.8 cm (SD ± 1.3). The mean of length of stay was 6.6 days (SD ± 2.7) while median GOS at discharge was found to be 4 (SD ± 1.2). Eighteen of the 48 patients were lost to follow up. Overall mortality was 14.6% (7 patients). There was a significant correlation between admission GCS and GOS at discharge (r = 0.87 and p = < 0.001).
Conclusion: The paediatric age group is more susceptible to central nervous system infections and cerebral abscess development. Moreover, the higher prevalence of congenital heart diseases, pulmonary disorders and head trauma leads to higher incidence, prolonged morbidity and increased mortality. Surgical interventions for brain abscess have good outcome. However, early diagnosis is the key to saving lives.
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