Introduction Tuberculosis of the central nervous system (CNS) remains endemic in developing countries with high morbidity and mortality despite advances in imaging and treatment. The objective of our work was to describe the diagnostic and therapeutic difficulties of this pathology in the context of a country with limited health resources. Materials and methods We retrospectively studied 8 cerebral tuberculosis abscess files, collected in the archives of the neurosurgery department of the Conakry University Hospital over a 5-year period (January 2013–December 2017). The diagnosis was made by scanning and by isolation of acid-fast bacilli (AFB) by direct examination of pus. Results Mean age was 33 years (9–56 years), sex, 5H 5 men/3F 3 women. History of pulmonary TB, 3 cases; TB contagious, 5 cases; TST ITR positive, 5 cases; associated visceral TB, 5 cases; HIV positive serology, 2 cases. The clinic was dominated by altered consciousness, 7 cases; focal signs, 7 cases; and fever, 5 cases. The site was hemispherical in 7 cases and one case in the posterior brain fossa. Treatment was medico-surgical in all patients. The evolution was favorable in 3 cases, the neurological sequelae in 3 cases, 2 cases of death, and 2 cases of recurrence. Conclusion Cerebral tuberculous abscesses constitute a medico-surgical emergency. Despite their rarity, morbidity and mortality remains high in the context of developing countries due to diagnostic and therapeutic delays.

Introduction: Brain abscesses are serious conditions that can be life-threatening if left untreated. The objective of our study was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of cerebral abscesses of otorhinolaryngological origin in our department. Methods and Materials: This was a retrospective study of 80 cerebral abscess files of otorhinolaryngological origin collected over a period of 5 years (January 2014-December 2018) at the neurosurgery department of Conakry University Hospital Center. Results: Abscesses of otorhinolaryngological origin represented 72% of all abscesses. The mean age was 14.7 years with a sex ratio of 4. The clinical picture was dominated by fever (92%), focal signs (55%) and intracranial hypertension (46%). The entrance door was 84% sinus. The frontal site was predominant, 44 cases. Eighty-two percent of patients underwent surgery and 18% were treated with antibiotic therapy alone. The evolution was favorable in 75% of the cases with a mortality rate of 15%. Conclusion: Brain abscesses are a medical-surgical emergency. The forms of otorhinolaryngologic origin are dominated by sinusitis. Despite the therapeutic difficulties, the prognosis remains acceptable in our study, 15% of deaths.

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