Intracerebral abscesses: outcome following management in the CT era

There are no pathognomonic presenting features of intracerebral abscesses. Their clinical features could be confused with those of a tumour or any other space occupying lesion.

We analyzed the symptoms, predisposing factors, diagnostic modalities, prevalent causative microbes, management and outcome in 11 patients, for whom complete records were available and who were managed for confirmed intracerebral abscess in our Neurosurgical Unit from 1996 to 2000 and compared our findings with those from other series.

In these patients focal neurological deficit was the most common clinical feature, trauma was the most predisposing event and Computerised Tomography (CT) Scanning remained the most dependable diagnostic tool. In our practice, burr hole drainage augmented with a minimum of 4 weeks intravenous antibiotics, was the most frequently used treatment modality.

The outcome was satisfactory (ability to return to pre-morbid activities and duties, with no disabling neurological deficits) in 72.8% cases. There was one death. This modality remains an effective way of treating patients with intracebrebral abscess.