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Brain abscess and subdural empyema

R M Levy1

  • 1Department of Neurosurgery, Northwestern University Medical School, Chicago, IL 60611.

Current Opinion in Neurology
|June 1, 1994
PubMed
Summary
This summary is machine-generated.

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Advances in diagnosing and treating brain abscesses and subdural empyema include improved imaging like MRI and novel tools. Minimally invasive surgeries and targeted antibiotics show promise, with patient consciousness and disease progression being key outcome predictors.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Neuroradiology

Background:

  • Brain abscesses and subdural empyema present significant diagnostic and management challenges.
  • Historically, high mortality rates associated with these conditions have been a major concern.

Purpose of the Study:

  • To review recent international contributions to the diagnosis and management of brain abscesses and subdural empyema.
  • To highlight advancements in diagnostic modalities and surgical techniques.
  • To identify key prognostic factors influencing patient outcomes.

Main Methods:

  • Review of recent international literature on brain abscesses and subdural empyema.
  • Analysis of diagnostic studies comparing various imaging techniques (CT, MRI, PET, scintigraphy) and biomarkers (CRP).

Related Experiment Videos

  • Evaluation of surgical approaches including stereotactic drainage, craniotomy, and burr hole drainage.

    • Main Results:

    • Computed tomography (CT) and early treatment have significantly reduced mortality.
    • Magnetic resonance imaging (MRI) demonstrates superiority over CT for subdural empyema detection; positron emission tomography (PET) shows potential value.
    • Novel diagnostic tools like 99mTc-HMPAO leukocyte scintigraphy and C-reactive protein (CRP) levels show promise.
    • Stereotactic drainage for brain abscesses and burr hole drainage for subdural empyema are effective, less invasive options.
    • Local antibiotic instillation may benefit refractory brain abscesses.
    • Patient's level of consciousness and disease progression rate are critical predictors of poor outcomes.

    Conclusions:

    • Modern diagnostic tools and early, appropriate treatment have drastically improved outcomes for brain abscesses and subdural empyema.
    • Less invasive surgical techniques are effective alternatives to traditional craniotomy.
    • Prognosis is strongly linked to the patient's neurological status and the speed of disease advancement before treatment initiation.