Stereotactic surgery in the management of brain abscess
1999; Elsevier BV; Volume: 52; Issue: 4 Linguagem: Inglês
10.1016/s0090-3019(99)00118-4
ISSN1879-3339
AutoresOrhan Barlas, Altay Sencer, Kaan Erkan, Haluk Eraksoy, Serra Sencer, Çiçek Bayındır,
Tópico(s)Infective Endocarditis Diagnosis and Management
ResumoBacterial brain abscesses can be diagnosed and treated with stereotactic aspiration.From 1991 to 1997 we have used computed tomography-guided stereotactic aspiration to diagnose and treat 21 patients with a total of 58 bacterial brain abscesses. The ages of the patients ranged from 4 to 72 years (median 25 years); 11 of these 21 patients had multiple abscesses. The number of abscesses per patient with multiple abscesses ranged from 2 to 9, all located deep in subcortical white matter.All patients underwent stereotactic surgical drainage and an 8-week intravenous antibiotic medical treatment. Of the 58 abscesses, 23 were aspirated. Of these 23 abscesses, 19 were radiologically stage III or IV and four were stage I or II. Pathological examination confirmed radiological staging in 19 patients (83%). Except for the three patients who have mild residual hemiparesis and one patient recovering from ataxia, all patients had complete neurological recovery.Computed tomography-guided stereotaxy achieved all the objectives of management; namely, ascertaining the diagnosis, draining the content of the mass, and obtaining pus for accurate bacteriological diagnosis without morbidity. Stereotactic aspiration combined with an 8-week intravenous antibiotic regimen has yielded an effective therapeutic result in all of our abscesses, small or large, solitary or multiple, superficial or deep-seated. A high radiological-pathological correlation was also deduced from this study.
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