Endoscopic treatment of brain abscess

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures
• Infectious Disease Management

Background:

• Brain abscess treatment remains controversial, with surgical aspiration being the primary approach.
• Endoscopic techniques offer an alternative to traditional methods, potentially improving visualization and efficacy.
• This study evaluates the outcomes of endoscopic aspiration for brain abscesses.

Purpose of the Study:

• To assess the safety and effectiveness of endoscopic aspiration in treating brain abscesses.
• To evaluate the role of endoscopy in managing complex or multiloculated brain abscesses.
• To compare endoscopic outcomes with existing treatment modalities.

Main Methods:

• A retrospective study of 12 brain abscess patients treated between January 2015 and January 2018.
• Inclusion criteria: brain abscesses larger than 3.0 cm in diameter.
• Treatment involved rigid endoscope-assisted aspiration, followed by CT scans and 3-6 months of follow-up.

Main Results:

• Eleven patients had a history of chronic otitis media; one had congenital cyanotic heart disease.
• Most patients presented with good Glasgow Coma Scores (14-15), except one critically ill patient.
• Complete recovery was observed in 11 out of 12 patients; no procedure-related complications occurred.
• Endoscopy facilitated visualization and opening of septations in 80% of multiloculated abscesses, enabling complete evacuation.

Conclusions:

• Endoscopic aspiration is a safe, straightforward, and effective treatment for brain abscesses.
• The technique provides excellent visualization for complete content aspiration and bleeding control.
• Endoscopy is particularly valuable for managing multiloculated abscesses by allowing septation opening, which may be challenging with other guided methods.