Brain Abscess

Chun, Chin Hak; Johnson, Judith D.; Hofstetter, M.; Raff, Martin J.

doi:10.1097/00005792-198611000-00006

Cited by 225 publications

(7 citation statements)

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“…Almost a third of patients received steroids before surgery, including a few patients initially suspected of brain tumours and more than half of surgically treated patients received at least temporary treatment with steroids after surgery. We were unable to demonstrate any clear benefit or risk associated with steroid use in agreement with previous studies [7,8,34]. …”

Section: Discussionsupporting

confidence: 81%

Pyogenic brain abscess, a 15 year survey

et al. 2012

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BackgroundBrain abscess is a potentially fatal disease. This study assesses clinical aspects of brain abscess in a large hospital cohort.MethodsRetrospective review of adult patients with pyogenic brain abscess at Rigshospitalet University Hospital, Denmark between 1994 and 2009. Prognostic factors associated with Glasgow Outcome Score (GOS) (death, severe disability or vegetative state) were assessed by logistic regression.Results102 patients were included. On admission, only 20% of patients had a triad of fever, headache and nausea, 39% had no fever, 26% had normal CRP and 49% had no leucocytosis. Median delay from symptom onset to antibiotic treatment was 7 days (range 0–97 days). Source of infection was contiguous in 36%, haematogenous in 28%, surgical or traumatic in 9% and unknown in 27% of cases. Abscess location did not accurately predict the portal of entry. 67% were treated by burr hole aspiration, 20% by craniotomy and 13% by antibiotics alone. Median duration of antibiotic treatment was 62 days. No cases of recurrent abscess were observed. At discharge 23% had GOS ≤3. The 1-, 3- and 12-month mortality was 11%, 17% and 19%. Adverse outcome was associated with a low GCS at admission, presence of comorbidities and intraventricular rupture of abscess.ConclusionsThe clinical signs of brain abscess are unspecific, many patients presented without clear signs of infection and diagnosis and treatment were often delayed. Decreased GCS, presence of comorbidities and intraventricular rupture of brain abscess were associated with poor outcome. Brain abscess remains associated with considerable morbidity and mortality.

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Section: Discussionsupporting

confidence: 81%

Pyogenic brain abscess, a 15 year survey

et al. 2012

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“…Brain abscess occurs in frontal and parietal lobes seen with frontal and ethmoid sinus infection. Chun et al 15 in his study, reported 40% of cases with brain abscess had permanent physical or mental disability, including hemiparesis, dysphagia and blindness. Mental status and degree of orientation at the time of diagnosis are important prognostic indicators as our patients were well oriented and responsive at the time of presentation, it lead to favorable outcome.…”

Section: Discussionmentioning

confidence: 93%

Intracranial and Orbital Complications of Sinusitis: A Case Series and Review of Literature

Vaidyanathan¹,

Shetty²

2011

An International Journal Clinical Rhinology

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Complications of paranasal sinus infection most often involve the orbit and periorbita. Because of widespread use of antibiotics, intracranial extension of paranasal sinusitis is rarely seen today. Nevertheless, the clinician must be aware of the potential of these complications, as late recognition of this condition and delay in treatment can increase morbidity and mortality rates. An interesting case series of sinusitis with orbital and intracranial complication is presented, which was radiologically evaluated, and was managed by endoscopic sinus surgery with drainage of subdural empyema by appropriate neurosurgical technique. The radiological tools played a very important role in both assessment and timing of surgical intervention. Unparallel role of radiological investigations cannot be overemphasized. The key to successful treatment is aggressive management and the timing for surgical intervention should not be deferred. The patients made full recovery at the time of discharge.

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“…There is a well known predominance of the male sex in patients with brain abscess [9,11,12,18,24,33]. Kagawa et al [19] observed a balanced male:female ratio of 1.1:1 in 62 children with brain abscess and CCHD.…”

Section: Discussionmentioning

confidence: 99%

Brain abscess in childhood-long-term experiences

1991

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A retrospective evaluation was performed on 28 cases of paediatric brain abscess (male: female ratio 2.5:1; mean age 9.4 years; range 2.8-16 years) diagnosed between 1967 and 1987. In 46%, congenital cyanotic heart disease was identified as a predisposing factor, likewise sinusitis, otitis media or mastoiditis in 29% and immunodeficiency in 11%. Pathogenesis remained unclear in 14%. Initial symptoms and signs were predominantly nonspecific; loss of consciousness occurred in 32% of cases, neurological deficit and seizures each in 25%. Since the availability of CT, both diagnostic delay after hospital admission and mortality were substantially reduced: mean delay from 8.4 to 3.0 days, and mortality from 23% to 0%. Seventeen patients (61%) had follow up examinations 9.6 years (mean) after the acute illness (range 1-21 years). Neurological sequelae were diagnosed in 35% of cases, epilepsy in 29%, epileptic potentials during EEG in 12%, and CNS scars in 50%. Psychological testing revealed no statistically significant differences compared to normal populations. CNS scars, and epilepsy and/or epileptic potentials were more common after excision (7 patients) when compared to patients treated by aspiration and/or antibiotics alone (21 patients). It is concluded that excision of brain abscess should be avoided whenever possible. Therapy of choice consists of the administration of adequate antibiotics with or without CT-guided needle aspirations.

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Brain Abscess

Cited by 225 publications

References 0 publications

Pyogenic brain abscess, a 15 year survey

Pyogenic brain abscess, a 15 year survey

Intracranial and Orbital Complications of Sinusitis: A Case Series and Review of Literature

Brain abscess in childhood-long-term experiences

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