Aspiration versus Excision in Management of Intracranial Abscesses
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- Category: Vol. 84, December 2016
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Aspiration versus Excision in Management of Intracranial Abscesses, AYMAN T.M. MOHAMED, AHMED Z.M. ZOHDI, KHALED S.M. ANBAR, MOHAMED M.M. SALAMA and MOHAMED A.M. ELBORADY
Abstract
Background: Brain abscess can be defined as a localized infection within the brain tissue. It begins as a focal area of infection called cerebritis, which subsequently changed to a collection of pus in a well-vascularized capsule.
Objectives: Our aim of this work is to compare between aspiration and excision of brain abscesses to clinical outcome and radiological outcome, recurrence, complication rate, postoperative antibiotic needed, and the duration of hospital stay.
Patients and Methods: This work was done over 26 patients presenting between November 2013 and June 2015 presenting with intracranial abscesses managed surgically either by aspiration through a burr hole or excision with open craniotomy and then followed up clinically and radiologically.
Results: Six patients (23%) underwent excision of their abscesses as the primary surgery. The remaining twenty patients (77%) underwent aspiration via a burr hole. Seven of them only needed aspiration once. And ten patients had repeated aspiration twice (in eight cases) or three times (in two cases). Three patients of them needed surgical excision after failed repeated aspiration. There were no residual or recurrence in the excision group. Post-operative antibiotic duration was shorter in the excision group. Five patients presenting with recurrence after long term management and all are from the aspiration group. six cases (50%) of the those who managed by excision along the course of the disease showed surgical complications.
Conclusions: In our work, we found that excision gave a better result regarding the duration of antibiotics, hospital stay with less residual/recurrence rate and overall cost of treatment. But aspiration gave us better results regarding the rate of morbidity and complications in the neurological condition.