Skip to main content
SpringerLink
Log in

CT-guided stereotactic aspiration and treatment of brain abscesses

An experience with 24 cases

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The present study reports our experience with stereotactic puncture, aspiration and drainage of brain abscesses in 24 patients from a series of 34 consecutive cases. In all patients an intracavitary catheter was left in place for external drainage and daily irrigation with antibiotics. The patients received pre- and postoperatively triple broad spectrum antibiotic treatment, associated with low dose steroids and anti-epileptic drugs. Follow-up CT scans showed immediate reduction of the abscess size and gradual diameter diminution of the enhancing ring structure until its disappearance. The clinical presentation, risk factors, aetiology, outcome, bacteriological and CT findings were analysed. Mortality in this series was 4%. The majority of patients (96%) had no or minimal disability according to the Glasgow Outcome Scale. Our results confirm the value of this treatment policy and suggest that the stereotactic technique is a simple and safe method with minimal mortality and morbidity in the treatment of the majority of chronic brain abscesses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barsoum AH, Lewis HC, Cannillo KL (1981) Nonoperative treatment of multiple brain abscesses. Surg Neurol 16: 283–287

    PubMed  Google Scholar 

  2. Basil AS, Rhavi B, Banerji AK, Tandon PN (1989) Multiple pyogenic brain abscesses: an analysis of 21 patients. J Neurol Neurosurg Psychiatry 1989 52: 591–594

    Google Scholar 

  3. Berg B, Franklin G, Guneo R, Boldrey E, Strimling B (1978) Nonsurgical cure of brain abscess: early diagnosis and follow-up with computerized tomography. Ann Neurol 3: 474–478

    PubMed  Google Scholar 

  4. Bidzinski J, Koszewski W (1990) The value of different methods of treatment of brain abscess in the CT era. Acta Neurochir (Wien) 105: 117–20

    Google Scholar 

  5. Black P, Graybill JR, Charache P (1973) Penetration of brain abscess by systematically administered antibiotics. J Neurosurg 138: 705–709

    Google Scholar 

  6. Boom WH, Tuazon CU (1985) Successful treatment of multiple brain abscess with antibiotics alone. Rev Infect Dis 7/2: 189–199

    Google Scholar 

  7. Broggi G, Franzini A, Peluchetti D, Servello D (1985) Treatment of deep brain abscesses by stereotactic implantation of an intracavitary device for evacuation and local application of antibiotics. Acta Neurochir (Wien) 76: 94–98

    Google Scholar 

  8. Chee CP, Coltheart GJ (1986) Cerebritis preceding cerrebral abscess formation: a report of three cases. Aust NZJ Surg 56: 657–660

    Google Scholar 

  9. Chun CH, Johnson JD, Hofstetter M, Raff MJ (1986) Brain abscess. A study of 45 consecutive cases. Medicine 65(6): 415–431

    PubMed  Google Scholar 

  10. Dyste GN, Hitchon PW, Menezes AH, Vangilder JC, Green GM (1988) Stereotactic surgery in the treatment of multiple brain abscess. J Neurosurg 69: 188–194

    PubMed  Google Scholar 

  11. Garfield J (1969) Management of supratentorial intracranial abscess: a review of 200 cases. BMJ 2: 7–11

    PubMed  Google Scholar 

  12. George B, Roux F, Pillon M, Thurel C, George C (1979) Relevance of antibiotics in the treatment of brain abscesses. Acta Neurochir (Wien) 47: 285–291

    Google Scholar 

  13. Gruszkievicz J, Doron J, Peyser E, Borovich B, Schaechter J, Front D (1982) Brain abscess and its surgical management. Surg Neurol 18: 7–17

    PubMed  Google Scholar 

  14. Hall WA, Martinez AJ, Dummer JS, Lunsford LD (1987) Nocardial brain abscess: diagnostic and therapeutic use of stereotactic aspiration. Surg Neurol 28: 114–118

    PubMed  Google Scholar 

  15. Heinemann HS, Barude AI, Osterholm JL (1971) Intracranial suppurative disease: early presumptive diagnosis and successful treatment without surgery. JAMA 218/10: 1542–1547

    Google Scholar 

  16. Itakura T, Yokote H, Ozaki F, Itatani K, Hayashi S, Komai N (1987) Stereotactic operation for brain abscess. Surg Neurol 28: 196–200

    PubMed  Google Scholar 

  17. Jennet B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480–84

    PubMed  Google Scholar 

  18. Kourtopoulos H, Holm SE, Norby SR (1983) The influence of steroids on the penetration of antibiotics into brain tissue and brain abscesses. An experimental study in rats. J Antimicrob Chemother 11: 245–249

    PubMed  Google Scholar 

  19. Kourtopoulos H, Holm SE, West KA (1981) The management of intracranial abscesses: comparative study between two materials with significantly different rates of mortality. Acta Neurochir (Wien) 56: 127–128

    Google Scholar 

  20. Krayenbühl HA (1967) Abscess of the brain. Clin Neurosurg 14: 25–44

    Google Scholar 

  21. Lunsford LD (1987) Stereotactic drainage of brain abscesses. Neurol Res 9: 270–274

    PubMed  Google Scholar 

  22. Miller ES, Dias PS, Uttley D (1988) CT scanning in the management of intracranial abscess: a review of 100 cases. Br J Neurosurg 2: 439–446

    PubMed  Google Scholar 

  23. Moussa AH, Dawson BH (1978) Computed tomography and the mortality rate in brain abscess. Surg Neurol 10: 301–304

    PubMed  Google Scholar 

  24. Nauta HJW, Contreras FL, Weiner RL, Crofford MJ (1987) Brain stem abscess managed with computed tomography-guided stereotactic aspiration. Neurosugery 20: 76–80

    Google Scholar 

  25. Nicola N, Sprick C (1987) Der Hirnabszess. In: Schirmer M (ed) Perimed, Erlangen

    Google Scholar 

  26. Ohaegbulam SC, Saddeqi NU (1980) Experience with brain abscesses treated by simple aspiration. Surg Neurol 13: 289–291

    PubMed  Google Scholar 

  27. Rosenblum ML, Hoff JT, Norman D, Weinstein PR, Pitts L (1978) Decreased mortality from brain abscess since advent of computerized tomography. J Neurosurg 49: 658–668

    PubMed  Google Scholar 

  28. Rousseaux M, Lesoin F, Destee A, Jomin M, Petit H (1985) Long term sequelae of hemispheric abscesses as a function of the treatment. Acta Neurochir (Wien) 74: 61–67

    Google Scholar 

  29. Stephanov S, Joubert MJ (1982) Large brain abscesses treated by aspiration alone. Surg Neurol 17: 338–340

    PubMed  Google Scholar 

  30. Wallenfang T, Bohl J, Kretzschmar K (1980) Evolution of brain abscess in cats. Formation of capsule and resolution of brain edema. Neurosurg Rev 2: 162–171

    Google Scholar 

  31. Wallenfang T, Reulen HJ, Schürmann K (1981) Therapy of brain abscess. In: Schiefer W, Klinger M, Brock M (eds) Advances in neurosurgery, Vol 9. Springer, Berlin Heidelberg New York, pp 41–47

    Google Scholar 

  32. Walsh PR, Larson SJ, Rytel MW, Maiman DJ (1980) Stereotactic aspiration of deep cerebral abscesses after CT-directed labeling. Appl Neurophysiol 43: 205–209

    PubMed  Google Scholar 

  33. Weisberg L (1984) Clinical-CT correlations in intracranial suppurative (bacterial) disease. Neurology 34: 509–510

    PubMed  Google Scholar 

  34. Whelan MA, Hilal SK (1980) Computed tomography as a guide in the diagnosis and follow-up of brain abscess. Radiology 135: 663–671

    PubMed  Google Scholar 

  35. Yang SY (1981) Brain abscess: a review of 400 cases. J Neurosurg 55: 794–799

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Bern, Inselspital Bern, Switzerland

    M. G. Hasdemir & U. Ebeling

Authors
  1. M. G. Hasdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Ebeling
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hasdemir, M.G., Ebeling, U. CT-guided stereotactic aspiration and treatment of brain abscesses. Acta neurochir 125, 58–63 (1993). https://doi.org/10.1007/BF01401829

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01401829

Keywords

Search

Navigation