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Brain abscess--diagnosis and management.

Ali Akbar Bhand1

  • 1Department of Neurosurgery, Chandka Medical College, VIP Road, Larkana, Sindh, Pakistan. alibhand@hyd.paknet.com.pk

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|July 29, 2004
PubMed
Summary

This study on brain abscesses found that early diagnosis with CT scans and surgical removal of the abscess capsule, alongside antibiotics, significantly reduces mortality and neurological deficits. Common causes included otogenic infections with Bacteroides and Streptococci.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Brain abscesses remain a significant cause of morbidity and mortality, particularly in developing regions.
  • Understanding the clinical presentation, causative organisms, and treatment outcomes is crucial for effective management.

Purpose of the Study:

  • To analyze the clinical features, diagnostic methods, infection sources, and surgical outcomes of brain abscess patients.
  • To identify the microorganisms involved and their antibiotic sensitivities in brain abscesses.

Main Methods:

  • A descriptive study was conducted over five years (1998-2003) at a tertiary care hospital.
  • Data from 82 confirmed brain abscess cases were collected, including demographics, clinical presentation, CT findings, surgical procedures, and microbiological results.

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Main Results:

  • Headache with papilledema (82%) and neurological deficits (46%) were common presentations. Otogenic sources (63%) were most frequent. CT scans were 100% diagnostic.
  • Bacteroides (38%) and Streptococci (25%) were the predominant isolates. Overall mortality was 22%, with septicemia, ventriculitis, and pneumonia as causes of death.

Conclusions:

  • Timely diagnosis using CT scans is essential for brain abscess management.
  • Complete surgical excision of the abscess capsule combined with appropriate antibiotic therapy can lower mortality and neurological deficits.