Analysis on Surgical Outcome of Brain Abscess.
- Author:
Sang Ryong JEON
1
;
Jeong Hoon KIM
;
Young Shin RA
;
Sung Woo ROH
;
Chang Jin KIM
;
Yang KWON
;
Jung Kyo LEE
;
Seung Chul RHIM
;
Byung Duk KWUN
Author Information
1. Department of Neurological surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Brain abscess;
Complication;
Empyema;
Fungal infection;
Stereotactic aspiration
- MeSH:
Abscess;
Anti-Bacterial Agents;
Brain Abscess*;
Brain*;
Cerebellum;
Empyema;
Female;
Follow-Up Studies;
Frontal Lobe;
Hip;
Humans;
Intracranial Pressure;
Male;
Medical Records;
Mortality;
Necrosis;
Polyneuropathies;
Rabeprazole;
Recurrence;
Risk Factors;
Seizures;
Sepsis
- From:Journal of Korean Neurosurgical Society
1999;28(8):1131-1136
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: This study was undertaken to review the mortality, complications, risk factors and the surgical outcome in long-term follow-up cases of brain abscess. METHODS: The authors studied medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from 1990 to 1997. RESULTS: There were 44 cases and the ratio of male to female was 32:12 which shows predominance in male. The ages of patients ranged from 2 to 73(average: 40). Lesions were located at frontal lobe in 16 cases, temporal in 8, parietal in 7, occipital in 5, cerebellum in 6, and multiple in 2. The ranges of follow-up periods were from 1 month to 96 months(average: 20.5 months). The primary origins of infection were found in only 15 cases(34%) and in 32 cases(73%), the organisms were identified from culture. The operative modalities were as follows; abscess aspiration (stereotactic or sono-guided) in 42 times and abscess excision in 13 times. There were 2 operations in 7 cases and 3 in 2 cases. In 2 cases, recurrences were occurred during antibiotics therapy after first operation. Three patients(6.8%) died due to sepsis in 2 cases, increased intracranial pressure in 1 case. We analysed 19 cases who were followed-up more than 12 months. In this group, there were intermittent seizures in 2 cases, antibiotics(metronidazole) induced polyneuropathy in 1 case, and avascular necrosis of hip in 2 cases which were suspected to have relation to long-term high dose steroid therapy. But there were no other sequalae or neurological deficits. CONCLUSION: The complication rate from long-term follow-up was high(26%) but the mortality rate was low(6.8%). Additionally, the findings such as multiple lesions, empyema, and fungal infection are suspected to be risk factors in mortality cases.
