Minim Invasive Neurosurg 2001; 44(3): 135-140
DOI: 10.1055/s-2001-18126
ORIGINAL PAPER
Georg Thieme Verlag Stuttgart · New York

Ultrasound-Guided Aspiration of Brain Abscesses Through a Single Burr Hole

M. Strowitzki, K. Schwerdtfeger, W.-I. Steudel
  • Department of Neurosurgery, Saarland University Medical School, Homburg/Saar, Germany
Further Information

Publication History

Publication Date:
31 October 2001 (online)

Surgical aspiration and/or drainage of brain abscesses is considered to be the first-line treatment for abscesses larger than 25 mm. This is ususally performed with the aid of CT-guided stereotaxy. A method of ultrasound guidance is presented that allows a single burr hole approach with real-time imaging of the whole procedure. A bayonet-like shaped ultrasound probe with tip dimension of 8 × 8 mm only (EUP-NS 32, Hitachi/Ecoscan) with frequencies of 3.5 and 5 MHz is used. After placement of a burr hole the target is identified by transdural insonation, a guideline is adjusted and a mounted puncture-adapter guides the cannula towards the lesion under real-time imaging control. Up to now 12 abscesses in 10 patients were treated. Visualization was always excellent. A second aspiration had to be performed twice. One abscess did not contain enough pus to be cured by aspiration and was removed by open surgery, another could not be tapped by the blunt cannula and was aspirated under stereotactic control using a sharp trocar. Outcome was excellent in 6 patients and fair in 2 patients but this was due to the pre-existing disease. Two patients admitted in deep coma died despite an emergency operation. The presented method has proven to be a very powerful guiding tool in the surgical treatment of brain abscesses through a single burr hole approach.

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Corresponding Author

M. Strowitzki,M. D. 

Department of Neurosurgery
Saarland University Medical School

Kirrberger Straße

66421 Homburg/Saar
Germany

Phone: + 49-6841-1624100

Fax: + 49-6841-1624480

Email: ncmrtr@med-rz.uni-saarland.de