Brain abscess: A review of 41 cases

Objective: The traditional treatment of brain abscess includes antibiotic therapy and surgical drainage or excision of the abscess. The treatment has still been controversial whether to aspirate or excise a brain abscess. We tried to find out the best treatment method in forty-one cases.Methods: In this study, we present the treatment results of forty-one cases of brain abscesses Six of 41 cases were treated nonsurgically and 35 were treated surgically. In the surgically treated group, aspiration method was applied to 31 cases and total excision method was used in only 4 cases.Results: Chronic otitis-mastoiditis was the major causative factor in the development of abscesses in 17 (42%) cases. S.aureus was the most common organism isolated in 9 (31%) of the brain abscesses. Abscess was single in 37 (90%) cases and multilocated in 4 (10%) cases. In this study, the aspiration, surgical excision and medical treatment methods were used in 31,4 and 6 cases respectively. The mortality rate was 10%.Conclusion: Although many treatment modalities are present in the literature, aspiration is the most preferable method because of low morbidity and mortality rates. This method not only provides the identification of the causative organism but also makes the treatment easier by decreasing the amount of the mass in the solitary abscesses with 3 cm in diameter and more. There is an increasing tendency to use aspiration as the first modality.

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