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Bacterial brain abscesses: an evaluation of 96 cases
Tayfun Hakan1, Nurgül Ceran, Ilknur Erdem
1Neurosurgery Department, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey. tayfunhakan@yahoo.com
The Journal of Infection
|September 27, 2005
Summary
Brain abscess remains a significant neurosurgery challenge. Surgical aspiration is the gold standard for diagnosis and treatment, though medical management can be effective in select cases.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- Brain abscess, despite recent advances, presents ongoing challenges in neurosurgical practice.
- The study addresses the persistent morbidity and mortality associated with brain abscesses.
Purpose of the Study:
- To retrospectively analyze 96 patients with brain abscess treated between 1988 and 2001.
- To evaluate clinical symptoms, etiologic factors, diagnostic and treatment methods, and outcomes in brain abscess cases.
Main Methods:
- Retrospective analysis of 96 patients with brain abscess.
- Data collected on patient demographics, clinical presentation, causative organisms, and treatment modalities (aspiration, excision, medical therapy).
Main Results:
- Surgical aspiration was the primary treatment for 72 patients; 14 underwent excision, and 10 received medical treatment alone.
- Mortality occurred in 8 patients (7 aspiration, 1 excision). 55 patients achieved a cure without morbidity.
- Significant correlations with mortality included initial neurologic grade, meningismus, high fever, and leukocytosis.
Conclusions:
- Surgical aspiration is considered the gold standard for brain abscess treatment, enabling definitive diagnosis and pathogen identification.
- While medical treatment can be successful in specific cases, surgery offers a more rapid cure.
- Prognostic factors such as neurologic grade and presenting symptoms are crucial for patient outcomes.