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Related Experiment Videos

Brain abscess. A study of 45 consecutive cases.

C H Chun, J D Johnson, M Hofstetter

    Medicine
    |November 1, 1986
    PubMed
    Summary
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    Despite advances in CT scanning for brain abscesses, diagnosis and treatment times remain unchanged, impacting morbidity and mortality. Early antibiotic treatment and careful lumbar puncture are recommended, with anaerobic bacteria being common culprits.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Radiology

    Background:

    • Brain abscesses are serious intracranial infections with significant morbidity and mortality.
    • Predisposing factors include infections of paranasal sinuses, ears, lungs, and odontogenic foci.
    • Common clinical presentations involve headache, fever, seizures, and focal neurological deficits.

    Purpose of the Study:

    • To analyze clinical features, diagnostic findings, therapeutic outcomes, and prognostic factors in patients with brain abscesses.
    • To evaluate the impact of computed tomography (CT) scanning on the diagnosis and management of brain abscesses.
    • To identify common causative organisms and optimal diagnostic and therapeutic strategies.

    Main Methods:

    • Retrospective analysis of 45 patients diagnosed with brain abscesses.

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  • Review of clinical data, diagnostic imaging (CT, 99mTc scanning, arteriography), laboratory results (blood and CSF cultures), and treatment outcomes.
  • Correlation of imaging findings with clinical presentation and response to therapy.

    • Main Results:

    • CT scanning increased diagnosis rates but did not decrease time to treatment or improve outcomes.
    • Headache, fever, seizures, and altered sensorium were common symptoms.
    • Anaerobic and microaerophilic bacteria were frequently isolated, often as single pathogens.
    • Ring-enhancing lesions were typical on CT scans, with slow resolution even with treatment.

    Conclusions:

    • Empirical antibiotic treatment is recommended for suspected brain abscesses.
    • Lumbar puncture should be performed cautiously due to risks of herniation and low diagnostic yield.
    • Imaging techniques like CT are crucial for diagnosis, though early scans may be negative.
    • Surgical excision or effective antibiotic therapy is necessary for abscess resolution.