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Experience with brain abscesses treated by simple aspiration
Abstract:
No deaths have occurred in 15 consecutive cases of intraparenchymatous brain abscesses in Nigerian patients who were treated by aspiration, systemic antibiotics, dexamethasone and anticonvulsants. Four patients had persistent convulsions which responded well to drug therapy and two patients had hemiparesis but were able to return to their jobs. The simplicity of this method of treatment and the results, achieved without the benefit of computerised tomographic scan, raise the question as to whether the recent trend towards excision of brain abscess is justifiable.
Insights
This study reports 15 successful treatments for intraparenchymal brain abscesses in Nigerian patients using aspiration and medication. The effective, simple treatment approach challenges the necessity of surgical excision for brain abscesses.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Neurology
Background:
- Intraparenchymal brain abscesses present a significant clinical challenge.
- Traditional treatment often involves surgical intervention.
Purpose of the Study:
- To evaluate the efficacy of a conservative treatment protocol for intraparenchymal brain abscesses.
- To compare this approach with surgical excision methods.
Main Methods:
- Treatment involved aspiration, systemic antibiotics, dexamethasone, and anticonvulsants.
- No cases utilized computerised tomographic scans for diagnosis or management.
- The study included 15 consecutive Nigerian patients.
Main Results:
- Achieved zero mortality in 15 consecutive cases.
- Managed persistent convulsions effectively with medication.
- Patients with hemiparesis were able to resume employment.
Conclusions:
- A conservative treatment strategy (aspiration, antibiotics, supportive drugs) is highly effective for intraparenchymal brain abscesses.
- This approach offers a simple, successful alternative to surgical excision, even without advanced imaging.
- The findings question the routine justification for surgical excision in brain abscess management.