Brain abscess and its surgical management

Area of Science:

• Neurosurgery
• Infectious Diseases
• Radiology

Background:

• Brain abscesses are serious intracranial infections requiring prompt and effective management.
• Treatment strategies have evolved, necessitating a review of outcomes.
• Understanding factors influencing mortality and morbidity is crucial for optimizing patient care.

Purpose of the Study:

• To review treatment outcomes for brain abscesses over a 23-year period.
• To evaluate the impact of different surgical techniques on mortality and neurological deficits.
• To highlight the role of diagnostic imaging in managing brain abscesses.

Main Methods:

• Retrospective review of 56 patients with brain abscesses (excluding posttraumatic cases).
• Surgical interventions included aspiration, radical excision, drainage, or combined approaches based on clinical status and abscess location.
• Analysis of operative mortality and postoperative neurological deficits.

Main Results:

• An overall operative mortality rate of 11% was observed.
• Conservative surgical techniques, particularly in subacute or chronic stages, were associated with lower mortality.
• Computerized tomography (CT) proved essential for accurate localization, diagnosis, and monitoring of brain abscesses.

Conclusions:

• Early surgical intervention in the subacute or chronic stages of brain abscess may lead to improved outcomes.
• Conservative surgical management is recommended, especially when functionally critical brain areas are involved, to minimize neurological deficits.
• The integration of computerized tomography (CT) is fundamental for the effective diagnosis, localization, and follow-up of brain abscesses.