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Single-center experience and evaluation of rare ıntracranial abscesses in childhood
Nihal Yildiz1, Zeynep Gökçe Gayretli Aydin2,3
1Faculty of Medicine, Department of Pediatric Neurology, Zonguldak Bülent Ecevit University, Zonguldak, Turkey. nihalyildiz661@gmail.com.
Insights
Pediatric intracranial abscesses (IA) are rare but can cause lasting neurological issues. Early diagnosis and effective treatment are crucial for improving outcomes in children with brain infections.
Area of Science:
- Pediatric Infectious Diseases
- Pediatric Neurology
- Neuroimaging
Background:
- Intracranial abscess (IA) is a rare pediatric infection.
- Common symptoms include headache, fever, and focal neurological deficits.
- IA can lead to significant long-term neurological deficits.
Purpose of the Study:
- To analyze the demographic, clinical, laboratory, and imaging characteristics of pediatric intracranial abscesses.
- To compare infratentorial and supratentorial abscesses in children.
- To identify factors influencing prognosis in pediatric IA cases.
Main Methods:
- Retrospective study of pediatric patients diagnosed with IA between 2011 and 2022.
- Classification of abscesses into infratentorial and supratentorial groups.
- Data collection included demographics, clinical presentation, MRI findings, treatment, and follow-up.
Main Results:
- 23 pediatric patients were included; common symptoms were fever (91.3%) and headache (39.1%).
- Post-operative procedures (30.4%) were the most frequent etiology.
- MRI revealed multiple supratentorial abscesses in 68.7% of cases; 13% experienced recurrence, and 13% had sequelae.
Conclusions:
- Intracranial abscess in children is a rare but serious condition.
- Effective management and timely intervention are vital for a better prognosis.
- Extended follow-up is necessary due to the potential for long-term neurological deficits.
Background:
Intracranial abscess (IA) is a rare disorder in childhood. Clinical manifestations of brain abscess include headache, fever, and focal neurological deficits. This study aimed to examine the demographic, clinical, laboratory, and imaging findings in children with IA.
Methods:
Children admitted to the pediatric infection service with a diagnosis of IA between 2011 and 2022 were included in the study. Abscesses were divided into two groups: infratentorial and supratentorial. Demographic characteristics of the patients, complaints, MRI findings, and follow-up data were recorded and compared between the two groups.
Results:
The study included a total of 23 patients, 9 (39.1%) of whom were male, with a mean age at diagnosis of 79.3 ± 65.4 months. The most common complaints were headache (39.1%), fever (91.3%), focal neurological deficits (60.9%), seizures, loss of consciousness (26.1%), and meningitis findings (60.9%). The most frequent etiology was post-operative procedures (30.4%), followed by a history of meningomyelocele (13%), and congenital heart disease (8.7%). On MRI, 68.7% of the supratentorial abscesses were multiple and commonly localized in the frontal and parietal regions. Treatment included ceftriaxone (82.6%), vancomycin (65.2%), meropenem (43.5%), metronidazole (34.8%), and linezolid (17.4%). The median hospitalization duration for patients was 32 days (range: 14-150). Of the patients, 34.8% were hospitalized and followed in the intensive care unit, and neurosurgery performed surgical interventions in 60.9% of cases, with evacuation in 21.7% of cases. In cultures, the causative agent was identified on average within 4 ± 1.3 days. Recurrence of abscess occurred in three (13%) cases, and 13% of cases had residual sequelae.
Conclusions:
Intracranial abscess is a rare infectious disease that can result in long-term neurological deficits requiring extended follow-up and treatment. A correct and effective approach also positively impacts the prognosis of patients.
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