Post-traumatic brain abscess: experience of 36 patients

Area of Science:

• Neurosurgery
• Infectious Diseases
• Trauma Surgery

Background:

• Post-traumatic brain abscesses represent a serious complication following head injuries.
• These abscesses constitute a notable percentage of all brain abscess cases.
• Understanding the management and outcomes is crucial for improving patient care.

Purpose of the Study:

• To analyze the clinical characteristics and management outcomes of post-traumatic brain abscesses.
• To evaluate the effectiveness of different surgical interventions.
• To identify factors influencing recurrence and mortality.

Main Methods:

• Retrospective review of 36 patients with post-traumatic brain abscesses over 18 years.
• Analysis of injury type (compound vs. closed head injury), presentation interval, and neurological deficits.
• Comparison of outcomes between primary abscess excision and initial aspiration followed by excision.

Main Results:

• External compound fractures were the most common cause (20 patients).
• Focal neurological deficits were more frequent in closed head injuries (p < 0.05).
• Primary excision had a low recurrence rate (1/20), while aspiration led to subsequent excision in 8/14 patients. Excision was necessary in 94.7% of external compound injuries.

Conclusions:

• Surgical excision is highly effective for post-traumatic brain abscesses, particularly in compound injuries.
• Early surgical intervention is critical, as delayed treatment or aspiration can increase the need for further procedures.
• Prompt management can reduce operative mortality, especially in the absence of preoperative herniation signs.