Abstract
Objective:To determine the clinical outcome of burr-hole aspiration of brain abscess.Methods:We analyzed 100 cases of intracranial abscess, treated surgically from January 2015 and October 2016 at Jinnah Postgraduate Medical Centre (JPMC). All patients were treated with burr hole aspiration. Medical records were analyzed for demographics, clinical presentation, predisposing factors, abscess location on imaging and clinical outcomes were charted.Results:The study included 100 patients with 73 (73%) males and 27 (27%) females with a mean age of 36.69±10.96 years. Mean duration of signs and symptoms was 8.50±4.2 days. The most common presenting complaint was altered sensorium in 70 (70%) patients and commonest source of infection was otitis media seen in 27 patients (27%). The GCS on presentation was 13 in 57 (57%) cases. The parietal region was the most common site in 43 patients (43%), followed by frontal region in 33 patients (33%). Complete resolution of abscess with recovery of preoperative neuro-deficit was seen in 77 (77%) patients and recovery with major neuro-deficit was observed in 10 (10%) cases while 13 (13%) patients expired.Conclusion:Early diagnosis, optimum follow-up and timely burr-hole aspiration are the keys in the proper management of brain abscess.
Highlights
Brain abscess is infrequent but potentially life-threatening infection
Brain abscess is more common in developing countries with an incidence of 8% compared to 1-2% in Western countries and poses a public health challenge.[5]
The study was conducted in the department of neurosurgery at Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2015 to October 2016, with Institutional Review Board (IRB) approval
Summary
Brain abscess is infrequent but potentially life-threatening infection. It involves a focal, intraparenchymal collection of pus[1] seeded by septic foci in contiguous or distant region(s). The pathogenesis of intracranial abscess requires inoculation of a microorganism into the brain parenchyma in an area of devitalized brain tissue or with poor microcirculation. The lesion evolves from early cerebritis to the stage of organization and capsule formation which is wellvascularized.[2,3] The mode of entry of organisms could be by contiguous spread, hematogenous dissemination, or following trauma.[4]. Brain abscess is more common in developing countries with an incidence of 8% compared to 1-2% in Western countries and poses a public health challenge.[5] Despite the advent of modern neurosurgical techniques, new antibiotics and
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