Improved Outcomes in the First 72 Days of Medical Management of Cerebral Abscess in Post-Traumatic Patients

Authors

  • Rana Zubair Mahmood Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore
  • Mukhtiar Ahmed Lakho Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore
  • Muhammad Ajmal Khan Ayaz Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore
  • Shahzeb Ahmad
  • Usama Mansoor
  • . Yasin Khan
  • Muhammad Anwar

DOI:

https://doi.org/10.36552/pjns.v28i1.959

Keywords:

Cerebral Abscess, conservative management

Abstract

Objective:  We studied the results of medical and surgical management of cerebral abscesses in post-traumatic patients after road traffic accidents (RTA).

Material and Methods:  It is a comparative observational study of 40 patients in Lahore General Hospital/Punjab Institute of Neurosciences (PINS), Lahore. Our patients were presented with fever, vomiting, headache, fits, etc.

Results:  The age range of our patients was 15-60 years. The mean age of our patients was 40 years, we gave medical management along with bed rest to all 40 patients (100%) for 3 weeks. Anti-epileptic, mannitol, antibiotics, and painkillers were the medication that was given. Our 30 (75%) patients who were managed medically, had headaches, and vomiting which did not resolve for we had to operate on the patients. Surgical management was done in 10 (25%) patients. Surgical excision was done in 9 (97%) patients and burr hole evacuation was done in 1 (3%) patients. All patients who recovered from medical management are those who were treated within 1st week after the occurrence of cerebral abscess.

Conclusion:  The results of medical management of cerebral abscess are better than surgical management if patients are treated during the first week after the occurrence of cerebral abscess. With good antibiotics etc.

References

Berndt M, Lange N, Ryang YM, Meyer B, Zimmer C, Hapfelmeier A, Wantia N, Gempt J, Lummel N. Value of diffusion-weighted imaging in the diagnosis of postoperative intracranial infections. World Neurosurgery, 2018;118:e245-e253.

Capua T, Klivitsky A, Bilavsky E, Ashkenazi-Hoffnung L, Roth J, Constantini S, Grisaru-Soen G. Group A streptococcal brain abscess in the pediatric population: case series and review of the literature. The Pediatric Infectious Disease Journal. 2018;37(10):967-970.

Campioli CC, Almeida NEC, O'Horo JC, Garrigos ZE, Wilson WR, Cano E, DeSimone DC, Baddour LM, Van Gompel JJ, Sohail MR. Bacterial brain abscess: an outline for diagnosis and management. The American Journal of Medicine. 2021;134(10):1210-1217.

Capua T, Klivitsky A, Bilavsky E, Ashkenazi-Hoffnung L, Roth J, Constantini S, Grisaru-Soen G. Group A streptococcal brain abscess in the pediatric population: case series and review of the literature. The Pediatric infectious disease journal, 2018;37(10):967-970.

Lange N, Berndt M, Jörger AK, Wagner A, Wantia N, Lummel N, Ryang YM, Meyer B, Gempt J. Clinical characteristics and course of primary brain abscess. Acta neurochirurgica. 2018;160:2055-2062.

Longo D, Narese D, Fariello G. Diagnosis of brain abscess: a challenge that Magnetic Resonance can help us win!. Epidemiology & Infection. 2018;146(12):1608-1610.

Lu CH, Chang WN, Lui CC. Strategies for the management of bacterial brain abscess. Journal of Clinical Neuroscience. 2006;13(10):979-985.

Maher G, Beniwal M, Bahubali V, Biswas S, Bevinahalli N, Srinivas D, Siddaiah, N. Streptococcus pluranimalium: emerging animal streptococcal species as causative agent of human brain abscess. World Neurosurgery. 2018;115: pp.208-212.

Miranda HA, Leones SMC, Elzain MA, Moscote-Salazar LR. Brain abscess: current management. Journal of neurosciences in rural practice. 2013;4(S01):S67-S81.

Moorthy RK, Rajshekhar V. Management of brain abscess: an overview. Neurosurgical Focus. 2008;24(6):E31-6-

Muzumdar D, Jhawar S, Goel A. Brain abscess: an overview. International journal of surgery. 2011;9(2):136-144.

Tunthanathip T, Kanjanapradit K, Sae-Heng S, Oearsakul T, Sakarunchai I. Predictive factors of the outcome and intraventricular rupture of brain abscess. J Med Assoc Thai. 2015;98(2):170-80.

Udayakumaran S, Onyia CU, Kumar RK. Forgotten? Not Yet. Cardiogenic Brain Abscess in Children: A Case Series–Based Review. World neurosurgery. 2017;107:124-129.

Widdrington JD, Bond H, Schwab U, Price DA, Schmid ML, McCarron B, Chadwick DR. Narayanan, M., Williams, J. and Ong, E. Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome. Infection. 2018;46:785-792.

Downloads

Published

2024-03-01

Issue

Section

Original Articles