Spontaneous Intraventricular Pneumocephalus

Arai, Nobuhiko; Tabuse, Masanao; Nakamura, Ayako; Miyazaki, Hiromichi

doi:10.1097/scs.0000000000003392

Cited by 5 publications

(1 citation statement)

References 9 publications

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“…2,[14][15][16] In contrast, abscess aspiration alone may provide a microbiological diagnosis, reduce mass effect, and minimize the risk of morbidity (i.e., neurovascular injury, intracerebral hemorrhage, delayed-onset epilepsy. 5,[16][17][18] However, to date there have been no randomized controlled trials comparing these approaches. 3 Furthermore, indications (e.g., lesion size, location, single or multiple, primary or recurrent) and timing for surgery remain unclear.…”

Section: Introductionmentioning

confidence: 99%

A Canadian National Survey of the Neurosurgical Management of Intracranial Abscesses

Kameda-Smith

Ragulojan

Hart

et al. 2022

Can. J. Neurol. Sci.

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Objective: Intracerebral abscess is a life-threatening condition for which there are no current, widely accepted neurosurgical management guidelines. The purpose of this study was to investigate Canadian practice patterns for the medical and surgical management of primary, recurrent, and multiple intracerebral abscesses. Methods: A self-administered, cross-sectional, electronic survey was distributed to active staff and resident members of the Canadian Neurosurgical Society and Canadian Neurosurgery Research Collaborative. Responses between subgroups were analyzed using the Chi-square test. Results: In total, 101 respondents (57.7%) completed the survey. The majority (60.0%) were staff neurosurgeons working in an academic, adult care setting (80%). We identified a consensus that abscesses >2.5 cm in diameter should be considered for surgical intervention. The majority of respondents were in favor of excising an intracerebral abscess over performing aspiration if located superficially in non-eloquent cortex (60.4%), located in the posterior fossa (65.4%), or causing mass effect leading to herniation (75.3%). The majority of respondents were in favor of reoperation for recurrent abscesses if measuring greater than 2.5 cm, associated with progressive neurological deterioration, the index operation was an aspiration and did not include resection of the abscess capsule, and if the recurrence occurred despite prior surgery combined with maximal antibiotic therapy. There was no consensus on the use of topical intraoperative antibiotics. Conclusion: This survey demonstrated heterogeneity in the medical and surgical management of primary, recurrent, and multiple brain abscesses among Canadian neurosurgery attending staff and residents.1

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