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Open craniotomy for brain abscess: A forgotten experience?

BACKGROUND: Brain abscess carries a high morbidity and mortality despite medical advances. In this paper, we present a single institution's experience with the surgical treatment of brain abscess. METHODS: We retrospectively analyzed 33 cases of intracranial abscess who underwent surgical treat...

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Autores principales: Gadgil, Nisha, Patel, Akash J., Gopinath, Shankar P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622376/
https://www.ncbi.nlm.nih.gov/pubmed/23607056
http://dx.doi.org/10.4103/2152-7806.109522
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author Gadgil, Nisha
Patel, Akash J.
Gopinath, Shankar P.
author_facet Gadgil, Nisha
Patel, Akash J.
Gopinath, Shankar P.
author_sort Gadgil, Nisha
collection PubMed
description BACKGROUND: Brain abscess carries a high morbidity and mortality despite medical advances. In this paper, we present a single institution's experience with the surgical treatment of brain abscess. METHODS: We retrospectively analyzed 33 cases of intracranial abscess who underwent surgical treatment between January 2001 and December 2009. Patients were treated with aspiration through a single burr hole, open aspiration with ultrasound guidance, or complete abscess resection. The medical records were analyzed for demographics, clinical presentation, predisposing factors, imaging, microbiological investigations, treatment, and outcomes. RESULTS: There were 26 male and 7 female patients, aged between 12 and 78 years. The most common predisposing factor was head trauma. Surgical excision of the abscess was performed in 22 patients, open aspiration in 9 patients, and burr-hole aspiration in 2 patients. Repeat surgical procedure was required in six patients. Mortality in this series was 21%. A favorable outcome (Glasgow outcome scale 4 and 5) was achieved in 54%. There was no significant correlation between outcome and age, predisposing factor, treatment modality, or culture results. CONCLUSIONS: In this series, most patients were treated with an open technique, either by surgical excision or open aspiration of brain abscess. An open technique may reduce the need for additional imaging, surgical treatment, and length of antibiotic therapy. In resource-limited settings, excision of brain abscess may play a more important role in patient management while maintaining favorable outcomes.
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spelling pubmed-36223762013-04-19 Open craniotomy for brain abscess: A forgotten experience? Gadgil, Nisha Patel, Akash J. Gopinath, Shankar P. Surg Neurol Int Original Article BACKGROUND: Brain abscess carries a high morbidity and mortality despite medical advances. In this paper, we present a single institution's experience with the surgical treatment of brain abscess. METHODS: We retrospectively analyzed 33 cases of intracranial abscess who underwent surgical treatment between January 2001 and December 2009. Patients were treated with aspiration through a single burr hole, open aspiration with ultrasound guidance, or complete abscess resection. The medical records were analyzed for demographics, clinical presentation, predisposing factors, imaging, microbiological investigations, treatment, and outcomes. RESULTS: There were 26 male and 7 female patients, aged between 12 and 78 years. The most common predisposing factor was head trauma. Surgical excision of the abscess was performed in 22 patients, open aspiration in 9 patients, and burr-hole aspiration in 2 patients. Repeat surgical procedure was required in six patients. Mortality in this series was 21%. A favorable outcome (Glasgow outcome scale 4 and 5) was achieved in 54%. There was no significant correlation between outcome and age, predisposing factor, treatment modality, or culture results. CONCLUSIONS: In this series, most patients were treated with an open technique, either by surgical excision or open aspiration of brain abscess. An open technique may reduce the need for additional imaging, surgical treatment, and length of antibiotic therapy. In resource-limited settings, excision of brain abscess may play a more important role in patient management while maintaining favorable outcomes. Medknow Publications & Media Pvt Ltd 2013-03-25 /pmc/articles/PMC3622376/ /pubmed/23607056 http://dx.doi.org/10.4103/2152-7806.109522 Text en Copyright: © 2013 Gadgil N http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Gadgil, Nisha
Patel, Akash J.
Gopinath, Shankar P.
Open craniotomy for brain abscess: A forgotten experience?
title Open craniotomy for brain abscess: A forgotten experience?
title_full Open craniotomy for brain abscess: A forgotten experience?
title_fullStr Open craniotomy for brain abscess: A forgotten experience?
title_full_unstemmed Open craniotomy for brain abscess: A forgotten experience?
title_short Open craniotomy for brain abscess: A forgotten experience?
title_sort open craniotomy for brain abscess: a forgotten experience?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622376/
https://www.ncbi.nlm.nih.gov/pubmed/23607056
http://dx.doi.org/10.4103/2152-7806.109522
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