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Post-traumatic brain abscess: experience of 36 patients
1Department of Neurosurgery, All India Institute of Medical Sciences, New Dehli.
British Journal of Neurosurgery
|January 1, 1995
Summary
Post-traumatic brain abscesses are rare, often resulting from head injuries. Surgical excision is the primary treatment, with higher recurrence rates after initial aspiration compared to primary excision.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- Post-traumatic brain abscesses represent a significant complication of head injuries.
- These abscesses constitute approximately 9.3% of all brain abscesses encountered.
Purpose of the Study:
- To analyze the management and outcomes of post-traumatic brain abscesses.
- To evaluate the effectiveness of different surgical interventions for these abscesses.
Main Methods:
- Retrospective review of 36 patients with post-traumatic brain abscesses managed over 18 years.
- Analysis of injury type (compound vs. closed head injury), interval to presentation, and surgical approaches (excision vs. aspiration).
Main Results:
- The mean interval from injury to abscess presentation was 113 days, with no significant difference based on injury type or wound status.
- Focal neurological deficits were more common in closed head injuries (p < 0.05).
- Primary abscess excision showed a lower recurrence rate (1/20) compared to initial aspiration followed by excision (8/14).
Conclusions:
- Surgical excision is the preferred method for managing post-traumatic brain abscesses, offering better outcomes than aspiration.
- External compound injuries have a higher requirement for excision and associated operative mortality compared to closed head injuries.