Intracranial abscesses : An institutional study.

Dr Yogendra Singh; Dr Tarun Kumar Gupta; Dr Gaurav Jaiswal; Dr Krishna Lodha.

Volume : IX, Issue : IV, April - 2020

Intracranial abscesses : An institutional study.

Dr Yogendra Singh, Dr Tarun Kumar Gupta, Dr Gaurav Jaiswal, Dr Krishna Lodha.

Abstract :

• Background – Brain abscess is defined as a focal intracranial infection that is initiated as an area of cereitis and evolves into a collection of pus surrounded by a vascularized capsule . These are complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Management involves both medical or surgical treatment. Surgical management includes either aspiration or excision of lesions larger than 2.5 cm in diameter, depending on ain location. However, literature on surgical treatment is replete with several procedures which, on their own, may not determine outcome. • Aim –Aim is to study the epidemiology, management and outcome of various treatment modalities of ain abscess in our institute. • Material and methods – We conducted a retrospective study of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses in patients admitted to our Neuro–intensive care unit at R.N.T. Medical College ,Udaipur, Rajasthan, India from January 2013 to June 2019. • Results – We carried out 53 procedures in 43 (30 male and 13 female) patients with various intracranial abscesses. Most abscesses [16, i.e. 37%] occurred in the second decade and second most common in the first decade [15, i.e 34%]. In infants 4 (9%) cases of intracranial abscesses were present. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (15) or posttraumatic (8). Most commonly abscesses were located in frontal 13 ( 30%) followed by cerebellar 9 ( 21%). Burr hole evacuation was done in 74% of cases. 3 patients ( 7% of cases) died. Prognosis appears to worsen with ventriculitis, multiple abscesses especially in infants, and immunosuppression. • Conclusion – In conclusion, ain abscess is a still continues to be a formidable challenge , with prognosis that dramatically improved over the last decades due to advances in ain imaging, neurosurgical techniques and better use of old and more recent antibacterial agents. Mortality is improved compared with historical series; however, long–term morbidity is significant particularly in the infant population. Further researches must be conducted to clarify specific aspects, such as anticonvulsant prophylaxis/therapy, and also for the improvement of microbiological diagnosis.