Cerrahi Olarak Tedavi Edilen Beyin Apselerinin Retrospektif Analizi: Tek Merkez Deneyimi

Bu çalışmada beyin apsesi nedeniyle opere edilen hastaların retrospektif incelenmesi amaçlandı. 2007-2016 yılları arasında kliniğimizce beyin apsesi nedeniyle opere edilen 29 hasta değerlendirilmeye alındı. Etkenin beyin dokusuna ulaşma yolu göz önüne alınarak hastalar 4 gruba ayrıldı. Grupların epidemiyolojik özellikleri, klinik bulguları, kan enfeksiyon parametreleri, hastaların mortalite ve reoperasyon oranları belirlendi. Tüm gruplardan birer örnek sunuldu. 29 hastanın 19’u erkek (%65.5), 10’u bayandı (%34.5). Ortalama yaş 39.2 idi. 29 hastanın 8’i direkt yayılım (%27.5), 6’sı hematojen (%20.6), 11’i kafa travması (%37.9), 4’ü iatrojenik (%13.7) yollarla apseye neden olmuştu. En sık yerleşim yeri temporal bölge ( %41.3) idi. 29 hastanın 8'i (%27.5) tekrar opere edildi. Toplam mortalite oranı %27.5 idi. Hastaların yaklaşık yarısında (%51.7) apse materyalinden alınan kültür pozitifdi. En sık saptanan patojen streptokok suşlarıydı. En sık görülen klinik bulgu başağrısı (%79.3) idi. Klasik intrakranial apse klinik triadı hastaların sadece 4’ünde (%13.7) mevcuttu. Sonuç olarak kafa travması ve cerrahi girişim sonrasında oluşan abselerde mortalite, komşu yapılardan direkt yayılım yoluyla oluşan apselerde ise reoperasyon oranı yüksek bulunmuştur.

Anahtar Kelimeler:

Beyin apsesi, Posttravmatik, Epidemiyoloji, Kültür, Mortalite

Retrospective Analysis of Surgically Treated Brain Abscess: A Single Center Experience

This study aimed to retrospectively investigate the patients who were operated due to brain abscess. 29 patients who were operated due to brain abscess in our clinic between 2007-2016 were evaluated. The patients were divided into 4 groups according to the way of reaching the brain tissue of the agent. The epidemiological characteristics, clinical findings, blood infection parameters, mortality and reoperation rates of the patients were determined. Illustrative cases for each group were presented. Nineteen of 29 patients were male (65.5%) and 10 were female (34.5%). The mean age was 39.2 years. 8 of 29 patients had a direct spread (27.5%), 6 hematogenous (20.6%), 11 head trauma (37.9%) and 4 iatrogenic (13.7%). The most common site was the temporal region (41.3%). Eight of 29 patients (27.5%) were re-operated. The overall mortality rate was 27.5%. Approximately half of the patients (51.7%) had positive culture from abscess material. The most common pathogenic strains were streptococci. The most common clinical finding was headache (79.3%). Clinical triad of classic intracranial abscess was present in only 4 (13.7%) patients. As a result, the rate of mortality was high in patients with head trauma and in abscesses that occurs after surgical intervention, and rate of reoperations was high in patients with direct spread from adjacent structures.

Keywords:

Brain abscess, Posttraumatic, Epidemiology, Culture, Mortality,

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