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[Brain abscess (80 cases)]
S Hilmani1, S Riyahi, K Ibahioin
1Service de neurochirurgie, CHU Ibn-Rochd, BP 20100, Casablanca, Maroc. hilmani.said@caramail.com
Background And Purpose:
Cerebral abscesses are focal suppurations of infectious origin developed within the cerebral parenchyma. This is a rare pathology, with a relatively poor prognosis. Therapy continues to be debated and the results are inconsistent. The objectives of this study were to define the factors influencing prognosis.
Methods:
In a search for predictive factors, we analyzed 80 observations of intracranial abscesses compiled between January 1990 and December 2004.
Results:
We noted a strong male prevalence (7:1) with age ranging from three to 65 years. The duration of symptoms was short in 34 patients (42.5%). A motor deficit existed in 25 cases (31.25%), aphasia in five patients, and seizure in 11. A CT scan in 77 patients and MRI in three patients provided the diagnosis in all patients. The supratentorial location was found in 72.5% of the cases. Otitis ranked first among etiologies, followed by cranial injuries and sinusitis. The pathogenic agent found in the pus from the abscess was seldom found at the entry point. Staphylococcus aureus was found in 12.1% of the cases, followed by Proteus (11.8% of the cases). Seventy-eight patients underwent surgery, two were treated with antibiotics only, with favorable progression in 76.3%. We noted a 13.1% rate of complications and five deaths.
Conclusions:
Comparing the data from this study with those of the literature, we observed that progression was better among young patients with a mean age of 20-35 years, a good level of consciousness, and supratentorial location.
Insights
This study analyzed 80 intracranial abscess cases to identify prognostic factors. Younger patients with good consciousness and supratentorial abscesses showed better outcomes, aiding cerebral abscess treatment strategies.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Context:
- Cerebral abscesses are rare infections of the brain parenchyma with variable prognoses.
- Current therapeutic strategies and their outcomes remain debated.
- Identifying factors influencing cerebral abscess prognosis is crucial for improving patient care.
Purpose:
- To define factors influencing the prognosis of cerebral abscesses.
- To analyze predictive factors for patient outcomes in intracranial abscesses.
Summary:
- A retrospective analysis of 80 intracranial abscess cases (1990-2004) revealed a male predominance and short symptom duration in many patients.
- Supratentorial location was common (72.5%), with otitis being a frequent etiology.
- Staphylococcus aureus and Proteus were identified pathogens; surgical intervention was common, with an overall favorable progression rate of 76.3%.
Impact:
- Prognosis appears better in younger patients (20-35 years) with good consciousness and supratentorial abscesses.
- Findings contribute to understanding cerebral abscesses and optimizing treatment approaches.
- This research aids in refining diagnostic and therapeutic strategies for brain abscesses.
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