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Brain abscesses in the young.

J R Spires, R J Smith, F I Catlin

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |August 1, 1985
    PubMed
    Summary
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    Brain abscesses are rare in children, often linked to congenital heart disease. Surgical drainage and antimicrobial therapy are crucial, but significant morbidity and mortality persist.

    Area of Science:

    • Pediatric Neurology
    • Infectious Diseases
    • Neurosurgery

    Background:

    • Brain abscesses in pediatric populations are infrequent, with only 14 cases documented at Texas Children's Hospital since 1968.
    • Congenital heart disease was the most common predisposing factor, identified in five patients.

    Observation:

    • Three cases involving sinusitis and mastoiditis as precipitating factors were analyzed in detail.
    • Clinical presentations frequently included signs of increased intracranial pressure (64% of patients).

    Findings:

    • Surgical drainage was performed in all cases, with some requiring repeated procedures.
    • Bacteriologic analysis revealed a mix of anaerobic (43%) and aerobic (36%) organisms, with polymicrobial infections in 14% of cases.
    • Despite antimicrobial therapy and surgical intervention, mortality was 21%, and residual neurological deficits occurred in one patient.

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    Implications:

    • This study highlights the challenges in managing pediatric brain abscesses, emphasizing the need for prompt diagnosis and intervention.
    • The persistent significant morbidity and mortality underscore the importance of further research into optimal treatment strategies and preventative measures.