Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Clinical Features and Surgical Results of Brain Abscesses

  • Park, Dae-Hee (Department of Neurosurgery, Bongseng Memorial Hospital) ;
  • Lee, Sang-Hoon (Department of Neurosurgery, Bongseng Memorial Hospital) ;
  • Lee, Kyoung-Soo (Department of Neurosurgery, Bongseng Memorial Hospital) ;
  • Chung, Ui-Wha (Department of Neurosurgery, Bongseng Memorial Hospital) ;
  • Park, Kang-Hwa (Department of Neurosurgery, Dongrae Bongseng Hospital) ;
  • Lee, Young-Woo (Department of Neurosurgery, Dongrae Bongseng Hospital)
  • Published : 2005.04.30
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Abstract

Objective: This study is undertaken to review the characteristics, risk factors and the surgical outcomes in long term follow-up of brain abscesses. Methods: We had reviewed medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from January 1992 to June 2003. Results: Observed 11 cases were comprised of 8 men and 3 women with 42 years old average age ranging from 17 to 66. Lesions were located at frontal lobe in 5 cases, parietal in 4 cases, temporal in 1 case, and occipital in 1 case. The mean follow-up period was 23.8 months and ranged from 5 to 33 months. The microbial sources of infection had been found in 5 cases (45%). The organisms were identified by using the microbial culture obtained from the excisional biopsy. We had applied all cases with surgical excision. Empirical antibiotic treatment started soon after diagnosis in all cases. The mortality and morbidity of surgical excision were low. Nine patients were neurologically improved. One patient had died after the operation due to acute respiratory distress syndrome (ARDS). Conclusion: The single and large abscess located in an accessible lesion is a good candidate for surgical excision because of it's low morbidity, mortality, and favorable outcome after surgical excision. Further study is required to compare the surgical excision with other treatment modalities of brain abscess.

Keywords

References

  1. Alderson D, Strong AJ, Ingham HR, Selkon JB : Fifteen-year review of the mortality of brain abscess. Neurosurgery 8 : 1-6, 1979 https://doi.org/10.1227/00006123-198101000-00001
  2. Apuzzo MLJ, Chandrasoma PT, Cohen D, Zee CS, Zelman V : Computed imaging stereotaxy:experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 20 : 930- 937, 1987 https://doi.org/10.1227/00006123-198706000-00019
  3. Beller AJ, Sahar A, Praiss I : Brain abscess:review of 89 cases over a period of 30 years. J Neurol Neurosurgery Psychiatry 36 : 757-768, 1973 https://doi.org/10.1136/jnnp.36.5.757
  4. Bhatia R, Tandon PN, Banerji AK : Brain abscess:an analysis of 55 cases. Int Surg 58 : 565-568, 1973
  5. Brewer NS, MacCarty CS, Wellman WE : Brain abscess : a review of recent experience. Ann Intern Med 82 : 571-576, 1975 https://doi.org/10.7326/0003-4819-82-4-571
  6. Buonaguro A, Colangelo M, Daniele B, Cantone G, Ambrosio A : Neurological and behavioral sequelae in children operated on for brain abscess. Childs Nerv Syst 5 : 153-155, 1989 https://doi.org/10.1007/BF00272117
  7. Carey ME, Chou SN, French LA : Experience with brain abscesses. J Neurosurg 36 : 1-9, 1972 https://doi.org/10.3171/jns.1972.36.1.0001
  8. Dyste GN, Hitchon PW, Menezes AH, Vangilder JC, Greene GM : Stereotaxic surgery in the treatment of multiple brain abscesses. J Neurosurg 69 : 188-194, 1988 https://doi.org/10.3171/jns.1988.69.2.0188
  9. Garfield J : Management of supratentorial intracranial abscess : a review of 200 cases. Br Med J 2 : 7-11, 1969 https://doi.org/10.1136/bmj.2.5648.7
  10. Gregory DH, Messner R, Zinneman HH : Metastatic brain abscesses : a retrospective appraisal of 29 patients. Arch Intern Med 119 : 25- 33, 1967 https://doi.org/10.1001/archinte.119.1.25
  11. Joubert MJ, Stephanov S : Computerized tomography and surgical treatment in intracranial suppuration : report of 30 consecutive unselected cases of brain abscess and subdural empyema. J Neurosurg 47 : 73-78, 1977 https://doi.org/10.3171/jns.1977.47.1.0073
  12. Jung KY, Lim YJ, Kim TS, Kim GK, Rhee BA, Leem W : Clinical analysis of brain abscess. J Korean Neurosurg Soc 21 : 977-992, 1992
  13. Kaufman DM, Leeds NE : Computed tomography(CT) in the diagnosis of intracranial abscesses. Neurology 27 : 1069-1073, 1977 https://doi.org/10.1212/WNL.27.11.1069
  14. Kim JS, Sung YS, Kang JK, Doh JY, Jung HT : Clinical analysis of the brain abscess. J Korean Neurosurg Soc 21 : 287-292, 1992
  15. Lee SH, Choi BK, Choi KS : Experience with 42 cases of brain abscess. J Korean Neurosurg Soc 10 : 739-745, 1981
  16. Lunsford LD, Nelson PB : Stereotactic aspiration of a brain abscess using the 'therapeutic' CT scanner:a case report. Acta Neurochir 62 : 25-29, 1982 https://doi.org/10.1007/BF01402208
  17. Mampalam TJ, Rosenblum ML : Trends in the management of bacterial brain abscesses : review of 102 cases over 17 years. Neurosurgery 23 : 451-458, 1988 https://doi.org/10.1227/00006123-198810000-00008
  18. Mathisen GE, Johnson JP : Brain abscess. Clin Infec Dis 25 : 763- 781, 1997 https://doi.org/10.1086/515541
  19. McClelland CJ, Craig BF, Crockard HA : Brain abscesses in northern ireland : a 30 year community review. J Neurol Neurosurg Psychiatry 41 : 1043-1047, 1978 https://doi.org/10.1136/jnnp.41.11.1043
  20. Miller ES, Dias PS, Uttley D : CT scanning in the management of intracranial abscess : a review of 100 cases. Br J Neurosurg 2 : 439- 446, 1988 https://doi.org/10.3109/02688698809029597
  21. Morgan H, Wood MW, Murphey F : Experience with 88 consecutive cases of brain abscess. J Neurosurg 38 : 698-704, 1973 https://doi.org/10.3171/jns.1973.38.6.0698
  22. New PFJ, Davis KR, Ballantine HT : Computed tomography in cerebral abscess. Radiology 121 : 641-646, 1976 https://doi.org/10.1148/121.3.641
  23. Osenbach RK, Loftus CM : Diagnosis and management of brain abscess. Neurosurg Clin N Am 3 : 403-420, 1992
  24. Park JH, Yoo DS, Kim DS, Huh PW, Cho KS, Kang JK : Continuous irrigation of brain abscess using a double lumen catheter. J Korean Neurosurg Soc 29 : 1328-1322, 2000
  25. Rosenblum ML, Hoff JT, Norman D, Weinstein PR, Pitts L : Decreased mortality from brain abscesses since advent of computerized tomography. J Neurosurg 49 : 658-668, 1978 https://doi.org/10.3171/jns.1978.49.5.0658
  26. Samson DS, Clark K : A current review of brain abscess. Am J Med 54 : 201-210, 1973 https://doi.org/10.1016/0002-9343(73)90224-6
  27. Stapleton SR, Bell BA, Uttley D : Stereotactic aspiration of brain abscesses : is this the treatment of choice? Acta Neurochir(Wien) 121 : 15-19, 1993 https://doi.org/10.1007/BF01405177
  28. Walsh PR, Larson SJ, Rytel MW, Maiman DJ : Stereotactic aspiration of deep cerebral abscesses after CT-directed labeling. Appl Neurophysiol 43 : 205-209, 1980
  29. Webster JE, Gurdjian ES : The surgical management of intracranial suppuration : methods in diagnosis and management, and a report of 23 cases of civilian and 33 cases of military abscess. Int Abstr Surg 90 : 209-235, 1950
  30. Wise BL, Gleason CA : CT-directed stereotactic surgery in the management of brain abscess. Ann Neurol 6 : 457, 1979 https://doi.org/10.1002/ana.410060517