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Management of brain abscesses. I: Drainage and antiseptics

Donald Simpson

    Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
    |December 21, 2013
    PubMed

    Insights

    Listerian antisepsis enabled early surgical treatment for brain abscesses. However, controlling microbial infection remained a challenge, leading to high mortality despite various treatments.

    Area of Science:

    • Neurosurgery
    • Infectious Diseases
    • Medical History

    Background:

    • Advances in neurology improved localization of brain abscesses.
    • William Macewen's 1893 monograph detailed pyogenic diseases of the brain and spinal cord.

    Observation:

    • Macewen reported on 20 cases of cerebral and cerebellar abscesses treated with surgical drainage and antiseptic precautions.
    • Initial surgical success was followed by reduced efficacy in later attempts.

    Findings:

    • Listerian antisepsis facilitated surgical intervention for brain abscesses.
    • Inability to control microbial infection was a key factor in treatment failures.
    • High mortality persisted despite the use of chemical antiseptics and serotherapy.

    Implications:

    • Early surgical interventions for brain abscesses showed promise but faced significant challenges.
    • The need for effective antimicrobial strategies in neurosurgery was highlighted.
    • Historical context reveals the evolution of treating lethal infections like brain abscesses.

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