Hemispheric brain abscess: a review of 46 cases

Brain abscess is a space occupying lesion that still prevails in many developing countries but less common in developed countries. It can be a preventable cause of fatal illness if diagnosed and treated appropriately. There is little or no information of the condition in Ghana. In this review we report our experience at the Neurosurgical unit of Korle Bu Teaching Hospital (KBTH) over a four year period.

A retrospective study of 46 patients with brain abscess(es) seen between January 1994-December 1998 was carried out at the Neurosurgical unit of KBTH, Accra, Ghana. Using hospital records of 46 patients an evaluation of computerized tomography (CT) scans of brain abscesses and the different methods of surgical treatment were made.

33 (72%) were male and 13 (28%) were female. 32 (70%) of the patients were aged 20 years or younger. Brain C.T. Scan was the main diagnostic imaging study performed on all the patients. In all but one case the diagnosis was a solitary abscess (98%). 38 patients (83%) had burr hole drainage under sedation and local anaesthesia and 12 under general anaesthesia. All patients were managed with appropriate antibiotics and steroids. There were 5 fatalities.

Simple burr hole drainage combined with appropriate medical treatment was found to be satisfactory in managing these patients.