Surgical Aspects in the Treatment of Brain Abscesses

Yu.A. Yasharov, V.I. Tsymbaliuk

Abstract


Objective of the study. Evaluating the effectiveness of various methods of surgical treatment of patients with brain abscesses. Materials and methods. The authors analyzed 242 cases of brain abscesses in patients from 6 regions of Ukraine for the period from 2000 to 2014. All patients underwent clinical and instrumental examination: analysis of anamnestic data, neurological examination, general clinical blood tests, examination by otoneurologist, neuroophthalmologist, computed tomography and magnetic resonance imaging. In all patients, culture-based analysis of abscess contents has been carried out. Results. All types of surgical interventions made in this study can be divided into the following types: total removal, puncture and drainage of abscesses, puncture method without the use of neuronavigation, by means of a framework or frameless navigation, combined method. Conclusions. The importance of neurosurgeon preferences and operating-room equipment should be stressed when choosing a method of treatment. Stereotactic treatments are currently the method of choice, especially in deep abscess, and abscesses located in functional areas. In multilocular abscesses, abscesses caused by anaerobic flora, in posttraumatic abscesses with the presence of foreign bodies, as well as in clinics with limited resources, the complete removal of an abscess may be a suitable method for the treatment of brain abscesses.


Keywords


brain abscess; stereotactic surgery; craniotomy

References


Гайдар Б.В. Практическая нейрохирургия. — СПб.: Гиппократ, 2002. — 648 с.

Гринберг М.С. Нейрохирургия: Пер. с англ. — М.: МЕДпресс-информ, 2010. — 1008 с.

Agarwal A.K., Garg R., Simon M. Ring enhancing lesion in CT scan: metastases or a brain abscess // Emerg. Med. J. — 2007. — Vol. 24. — P. 706.

Alderson P.O., Gado M.H., Siegel B.A. Computerized cranial tomography and radionuclide imaging in the detection of intracranial mass lesions // Semin. Nucl. Med. — 1977. — Vol. 7. — P. 161-173;

Barlas O., Sencer A., Erkan K., Eraksoy H., Sencer S., Bayindir C. Stereotactic surgery in the management of brain abscess // Surg. Neurol. — 1999. — Vol. 52. — P. 404-11.

Beller A.J., Sahar A., Praiss I. Brain abscess. Review of 89 cases over a period of 30 years // J. Neurol. Neurosurg. Psychiatry. — 1973. — Vol. 36. — P. 757-768.

Bernardini G.L. Diagnosis and management of brain abscess and subdural empyema // Curr. Neurol. Neurosci. Rep. — 2004. — Vol. 4. — P. 448-456.

Britt R.H., Enzmann D.R. Clinical Stages of Human brain abscesses on Serial CT Scans After contrast infusion // J. Neurosurg. — 1983. — Vol. 59. — P. 72-89.

Calfee D.P., Wispelwey B. Brain abscess // Semin. Neurol. — 2000. — Vol. 20. — P. 353-360.

Carpenter J., Stapleton S., Holliman R. Retrospective analysis of 49 cases of brain abscess and review of the literature // Eur. J. Clin. Microbiol. Infect. Dis. — 2007. — Vol. 26. — P. 1-11.

Cavusoglu H., Kaya R.A., Turkmenoglu O.N., Colak I., Aydin Y. Brain abscess: Analysis of results in a series of 51 patients with a combined surgical and medical approach during an 11-year period // Neurosurg. Focus. — 2008. — Vol. E9. — P. 24.

Erdogan E., Izci Y., Gonul E., Timurkaynak E. Ventricular injury following cranial gunshot wounds: clinical study // Mil. Med. — 2004. — Vol. 169. — P. 691-695.

Gortvai P., De Louvois J., Hurley R. The bacteriology and chemotherapy of acute pyogenic brain abscess // Br. J. Neurosurg. — 1987. — Vol. 1. — P. 189-203.

Hakan T. Bacterial brain abscesses: an evaluation of 96 ca-ses // J. Infect. — 2006. — Vol. 52. — P. 359-366.

Hakan T. Management of bacterial brain abscesses // Neurosurg. Focus. — 2008. — Vol. E4. — P. 24.

Hall W.A., Truwit C.L. The surgical management of infections involving the cerebrum // Neurosurgery. — 2008. — Vol. 62. — P. 519-31;

Kao P.T. Brain abscess:clinical analysis of 53 cases // J. Microbiol. Immunol. Infect. — 2003. — Vol. 36, № 2. — P. 129-136.

Karasu A., Cansever T., Sabancı P.A., Kiris T., Imer M., Oran E. et al. Craniocerebral civilian gunshot wounds: one hospital’s experience // Ulus Travma Acil Cerrahi Derg. — 2008. — Vol. 14. — P. 59-64.

Kocherry X.G., Hegde T., Sastry K.V., Mohanty A. Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses // Neurosurg. Focus. — 2008. — Vol. E13. — P. 24.

Loftus C.M., Osenbach R.K., Biller J. Diagnosis and management of brain abscess // Wilkins R.H., Rengachary S.S. (eds). Neurosurgery. — 2nd ed. — New York: McGraw-Hill, 1996. — Vol. 3. — P. 3285-3298.

Mamelak A.N., Mampalam T.J., Obana W.G., Rosenblum M.L. Improved management of multiple brain abscesses: a combined surgical and medical approach // Neurosurgery. — 1995. — Vol. 36. — P. 76-86.

Mampalam T.J., Rosenblum M.L. Trends in the management of bacterial brain abscesses: A review of 102 cases over 17 years // Neurosurgery. — 1988. — Vol. 23. — P. 451-8.

Mathisen G.E., Johnson J.P. Brain abscess // Clin. Infect. Dis. — 1997. — Vol. 25. — P. 763-81.

Ng P.Y., Seow W.T., Ong P.L. Brain abscesses: review of 30 cases treated with surgery // Aust N. Z. J. Surg. — 1995. — Vol. 65. — P. 664-666.

Nisha Gadgil, Akash J. Patel, and Shankar P. Gopinath: Open craniotomy for brain abscess: A forgotten experience? // Surg. Neurol. Int. — 2013. — Vol. 4. — P. 34.

Osenbach R.K., Loftus C.M. Diagnosis and management of brain abscess // Neurosurg. Clin. N. Am. — 1992. — Vol. 3. — P. 403-420.

Ratnaike T.E., Das S., Gregson B.A., Mendelow A.D. A review of brain abscess surgical treatment-78 years: Aspiration versus excision // World Neurosurg. — 2011. — Vol. 76. — P. 431.

Roche M., Humphreys H.E., Phillips J., Cunney R., McNamara E. et al. A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology // Clin. Microbiol. Infect. — 2003. — Vol. 9. — P. 803-809.

Salzman C., Tuazon C.U. Value of the ring-enhancing sign in differentiating intracerebral hematoms and brain abscess // Arch. Intern. Med. — 1987. — Vol. 147. — P. 951-952.

Sharma B.S., Gupta S.K., Khosla V.K. Current concepts in the management of pyogenic brain abscess // Neurol. India. — 2000. — Vol. 48. — P. 105-111.

Stapleton S.R., Bell B.A., Uttley D. Stereotactic aspiration of brain abscesses: is this the treatment of choice? // Acta Neurochir. — 1993. — Vol. 121. — P. 15-19.

Takeshita M., Kagawa M., Izawa M., Takakura K. Current treatment strategies and factors influencing outcome in patients with bacterial brain abscess // Acta Neurochir. (Wien). — 1998. — Vol. 140. — P. 1263-1270.

Tattevin P. Bacterial brain abscess // Am. J. Med. — 2003. — Vol. 115, № 2. — P. 143-146.

Wise B.L., Gleason C.A. CT-directed stereotactic surgery in the management of brain abscess // Ann. Neurol. — 1979. — Vol. 6. — P. 457.

Xiao F., Tseng M.Y., Teng L.J., Tseng H.M., Tsai J.C. Brain abscess: clinical experience and analysis of prognostic factors // Surg. Neurol. — 2005. — Vol. 63. — P. 442-450.

Yang S.Y. Brain abscess: A review of 400 cases // J. Neurosurg. — 1981. — Vol. 55. — P. 794-799.

Yang S.Y., Zhao C.S. Review of 140 patients with brain abscess // Surg. Neurol. — 1993. — Vol. 39. — P. 290-296.




DOI: https://doi.org/10.22141/2224-0586.7.70.2015.78732

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