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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(03): 483-487
DOI: 10.4103/ajns.AJNS_467_20
Original Article

Analysis of 93 brain abscess cases to review the effect of intervention to determine the feasibility of the management protocol: A tertiary care perspective

Sambuddha Dhar
Department of Neurosurgery, Institute of Medical Sciences-Banaras Hindu University, Varanasi, Uttar Pradesh
,
Barnava Pal
1   Department of Anesthesiology, Institute of Medical Sciences-Banaras Hindu University, Varanasi, Uttar Pradesh
2   Department of Anesthesiology, JIMSH, Kolkata, West Bengal
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Context: Brain abscess is a suppurative process within the brain parenchyma, which remains a challenge for clinicians. Surgical excision or aspiration combined with prolonged antibiotics (usually 4–8 weeks) or only conservative management remains the treatment of choice. Aims: The purpose of this study is to analyze the epidemiology of brain abscess and to determine the potential factors leading to better outcomes. Settings and Design: This was a retrospective analysis of 93 patients undergoing various treatment options for brain abscess in a tertiary care center. Materials and Methods: Their preoperative status, etiology, and microbiological and clinical outcomes were analyzed. Statistical Analysis Used: Statistical analysis was done by Chi-square, one-way analysis of variance, and post hoc Newman–Keuls multiple comparison test wherever applicable using SPSS software. Results: Among 93 brain abscess cases, only 21 cases had a diameter <2.5 cm. Among them, conservative treatment was done for 38% of patients (8/21), aspiration for 47.6% (10/21) of patients, and excision for only 3 (14.2%) of cases. About 37.5% (3/8) persons among these conservatively managed patients had recurrence. None of the patients of <2.5 cm abscess having surgical management had recurrence or any new neurological deficits postsurgery during the 6-month follow-up. Conclusions: There was a significantly high recurrence among the nonsurgically treated patients with lesions <2.5 cm and there was no recurrence or neurological deficit after aspiration among these patients. Probably, aspiration has better results among these patients contrary to previous recommendations of antibiotic therapy alone.

Key-words:

Abscess size - aspiration - brain abscess - craniotomy - recurrence

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 11. Oktober 2020

Angenommen: 10. April 2021

Artikel online veröffentlicht:
16. August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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