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[Bacterial brain abscess--experiences with 67 patients]

P Berlit1, C Fedel, K Tornow

  • 1Neurologische Klinik am Alfried Krupp Krankenhaus Essen.

Fortschritte Der Neurologie-Psychiatrie
|August 1, 1996
PubMed
Summary

This study on brain abscesses found that early diagnosis and treatment, especially with computed tomography (CT) guided aspiration, significantly improved survival rates. Poor outcomes were linked to patient age, consciousness level, multiple abscesses, and hematogenic causes.

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Historical review: a short history of German neurology - from its origins to the 1940s.

Neurological research and practice·2020

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Context:

  • Brain abscesses are serious intracranial infections with significant morbidity and mortality.
  • Management strategies have evolved over time, influenced by diagnostic and therapeutic advancements.

Purpose:

  • To analyze the clinical characteristics, management, and outcomes of brain abscess patients over a 19-year period.
  • To identify predictors of mortality and functional recovery in brain abscess cases.

Summary:

  • A series of 67 patients with brain abscesses revealed male predominance and a wide age distribution.
  • Hematogenic spread from lung infections and sepsis were common etiologies, alongside otolaryngologic and traumatic causes.
  • Neurologic deficits, altered consciousness, and seizures were frequent presentations; staphylococci and anaerobic pathogens were common culprits.

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  • Computed tomography (CT) enabled minimally invasive aspiration, reducing mortality from 62% (antibiotics alone) to 9% in the treated subgroup.
  • Overall mortality was 37%, with good recovery in 29/42 survivors. Predictors of poor outcome included advanced age, low consciousness level, multiple abscesses, polybacterial infections, and hematogenic origin.

    • Impact:

    • The introduction of CT-guided aspiration marked a significant improvement in brain abscess management and patient survival.
    • Understanding prognostic factors aids in risk stratification and tailoring treatment strategies for better patient outcomes.