Long-term insights into brain abscess management: An 8-year study from a single center in India

Both industrialized and developing nations continue to face difficulties in diagnosing and treating brain abscesses. Their etiology and management are still complicated and uncertain, which make treatment and result challenging.

To ascertain management, demographics, and factors influencing the outcome of subjects with brain abscesses, we performed a retrospective analysis of data from 48 individuals who underwent surgical treatment for brain abscesses at Mahatma Gandhi Hospital in Jaipur between January 2015 and December 2023 using image-guided aspiration, craniotomy, and excision. Independent analyses were conducted on variables such as age, gender, clinical presentation, location, number of lesions, predisposing factors, etiological agent, infection mechanism, therapy, and Glasgow Coma Scale (GCS) score during admission.

The risk of developing a brain abscess was higher for male patients over 40. The outcome was influenced by the admission GCS score. Only 16 instances (33.3%) had positive cultures, despite the low incidence of successful infectious agent culture. The most frequent isolates in these cases were Streptococcus sp. and tubercular abscess. While the death rate was 10.4%, 89.5% of the participants had favorable outcomes. Five patients had poor outcomes because of immunosuppression in two of them, a 1.8-year-old child had ventriculitis, and the other two had low GCS scores.

An efficient treatment for brain abscesses that have generally positive results is medical care combined with image-guided suction. excision and craniotomy are rarely necessary. Neither surgical technique nor surgery was directly associated with brain abscess mortality.