Brain abscess Analysis of pathophysiology and clinical spectrum.

T.Suresh Babu; Suresh Babu Thangavelu

Volume : VII, Issue : VI, June - 2017

Brain abscess Analysis of pathophysiology and clinical spectrum.

T. Suresh Babu, Suresh Babu Thangavelu

Abstract :

Introduction Brain abscess is defined as a focal, intra cereal infection that begins as a localized area of cereitis and develops into a collection of pus surrounded by a well–vascularized capsule. Although rare in developed countries ain abscess still remains a significant health care problem in developing countries . A each in any of the barriers of the Brain like thick skull vault ,tough duramater ,and important barriers like bloodain barrier and blood csf barrier. leads to entry of microorganisms into the ain initiating a suppurative inflammation culminating in ain abscess.The inciting organism can be introduced from outside by trauma or endogenously from infection in a contiguous site eg.ear or occasionally bloodborne. Although the portal of entry of the organism is commonly identified ,the organism remains obscure in 10 –37% of the patients. In the recent decades the addition of CT and MRI to the diagnostic armamentarium has facilitated early identification and thereby prompt institution of therapy in ain abscess .Improved microbiological techniques and advanced surgical techniques viz.stereotactic guided aspiration , real–time ultrasound imaging have caused a paradigm shift in the management and outcome of ain abscess.Despite these advancements ain abscess remains a serious infection with a mortality rate of 5–15% which escalates to as high as 80% in case of rupture. In this study we aim to observe and analyse the clinical profile, radiological features, management and outcome of patients admitted in our institute with ain abscess over a period of three years. Materials and methods All patients admitted in the Institute of Neurology, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai, between august 2010 and December 2012, with ain abscess were included in this study. On admission patients clinical profile such as age, sex, admission GCS, presenting symptoms and signs were recorded. All patients were subjected to CT scan ain plain study. In patients having ain abscess the following features were noted – location, number of abscess, loculation, associated hydrocephalus.Patients were either managed conservatively or by surgery. Outcome analysis was done at the time of discharge. Results– The overall results of this study in a total of 60 patients was a higher male to female ratio with significant pediatric involvement which showed higher mortality and morbidity compared to adult cohorts and a predominant parietal lobe involvement with the majority of abscesses showing being solitary and with no bacteriological growth with staphylococcus being the commonest organism. Commonest symptoms were fever, headache and vomiting, CSOM was the most common inciting cause and patients with sepsis had 100% mortality.