CLINICAL STUDY OF BRAIN ABSCESS AND ITS TREATMENT WITH REPEATED ASPIRATIONS AND OUTCOME

CORRESPONDING AUTHOR:
Dr. Ramachandra Rama Mohan Naik,
Assistant Professor,
Department of Neuro Surgery,
Osmania Hospital, Afjalgunj,
Hyderabad – 500024, Telangana.
E-mail: rammohan_naik@yahoo.co.in

ABSTRACT: BACKGROUND: Cerebral abscess is a serious life threatening complication of several diseases like CSOM congenital heart disease and trauma. Aspirations of abscess cavity verses excision of capsute are still in debate for the capsulated large abscess. Repeated aspirations is a good alternative for the patient who are not fit for surgical excision and deep seated abscess which are located in eloquent areas. The objective of this study is to look for the clinical presentation etiological factors and outcome of patients with repeated aspiration is brain abscess. METHODS: The prospective study was conducted in department of Neurosurgery, Osmania General Hospital, Hyderabad from June 2009 to June 2012, 24 patients; age ranges from 2 to 70 years. After through clinical examinations and work up patients were subjected to operate procedure. The procedure includes aspiration of brain abscess with single burr hole, followed repeat CT scan then repeated aspiration if required, under anti-biotic cover. Data regarding age and sex distribution, site of abscess, clinical presentation, outcome of patients after threatened with repeated aspiration were analyzed. RESULTS: First and second decade is commonly affected age consist of 50% of cases, males are commonly affected 83% and 16.6% were females cerebellum is the commonly affected 29.2% (7) less common is occipital lobe 4%,⁽¹⁾ CSOM is commonest predisposing factor 10 patients (41.6%) followed by congenital heart diseases 5 (20%). Fever and headache is commonest presentation 54.2% and 45.8%. CONCLUSION: Brain abscess resulting from CSOM is the common cause, Males are most commonly affected, commonest site of brain abscess is cerebellar followed by parietal lobe, Plain CT scan brain with contrast is the main investigation of choice in diagnosis of brain abscess. Repeated aspirations is safe and with less mobility and mortality. when the size of abscess remains same after repeat aspiration may need excision.

KEYWORDS: Brain abscess. Repeated aspitations.