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Results for “Brain Abscess”

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PubMed1998

Brain abscess and necrotic or cystic brain tumor: discrimination with signal intensity on diffusion-weighted MR imaging.

OBJECTIVE: The purpose of this study was to determine the differences in signal intensity between brain abscesses and necrotic or cystic tumors on diffusion-weighted MR imaging. CONCLUSION: Five consecutive patients with proven brain abscesses and four patients with proven cystic or necrotic brain tumors were prospectively evaluated with diffusion-weighted imaging. On diffusion-weighted imaging, brain abscesses showed markedly hyperintense signal in all five patients, whereas necrotic or cystic brain tumors revealed hypointense signal in all four patients. Diffusion-weighted imaging may allow the differentiation of brain abscess from necrotic or cystic brain tumor.

Adolescent↗
PubMed2001

[Analysis of 48 cases of brain abscess].

To analyze brain abscess for its origins of infection, diagnosis, and methods of treatment, 48 patients with brain abscess were retrospectively reviewed and they were treated with nonoperative way, puncture and aspiration, and resection. The results were that the cure rate was 81.25%, the improvement was 12.5%, and the mortality was 6.25%. The chronic otogenic infection and cryptogenic infection are the main origins of infection of brain abscess. The diagnosis of brain abscess depends on CT and MRI, and methods of its treatment are decided by the condition and speciality of brain abscess.

Adolescent↗
PubMed1992

Brain abscess: an update.

Brain abscess has been a known complication of head trauma, dental and rhinogenic infections and congenital heart defects, but is rapidly becoming a new diagnosis in the ever-growing population of the immunocompromised patient. Organ transplantation has become commonplace. But, with the advent of more sophisticated agents to prevent organ rejection, comes the threat of brain abscess. In addition to the transplanted patient, the acquired immunodeficiency syndrome patient population is also at risk for development of brain abscess, making brain abscess an important diagnosis. A combination of surgical excision and antimicrobial therapy is usually indicated. Nursing care of these patients involves current knowledge of the antimicrobial agents used and their adverse effects, as well as availability of home health services and need for follow-up care.

Brain Abscess↗
PubMedDate not supplied

Diffusion-weighted MRI features of brain abscess and cystic or necrotic brain tumors: comparison with conventional MRI.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) can be used to distinguish brain abscesses from cystic or necrotic brain tumors, which are difficult to distinguish by conventional magnetic resonance imaging (MRI) techniques. METHODS: Eleven consecutive patients with brain abscesses [10 pyogenic and 1 toxoplasmosis (in an AIDS patient)] and 15 with cystic or necrotic brain gliomas or metastases were enrolled in this study. None of these lesions had apparent hemorrhage based on T1-weighted image (T1WI). The DWI was performed using a 1.5-T system, single-shot spin-echo echo-planar pulse sequence with b=1000 s/mm(2). The ADC was calculated using a two-point linear regression method at b=0 and b=1000 s/mm(2). The ratio (ADCR) of the lesion ADC to control region ADC was also measured. RESULTS: Increased signal was seen in all of the pyogenic abscess cavities to variable degrees on DWI. In vivo ADC maps showed restricted diffusion in the abscess cavity in all pyogenic abscesses [0.65+/-0.16 x 10(-3) (mean+/-S.D.) mm(2)/s, mean ADCR=0.63]. The case with multiple toxoplasmosis abscesses showed low signal intensity on DWI and high ADC values (mean 1.9 x 10(-3) mm(2)/s, ADCR=2.24). All cystic or necrotic tumors but one showed low signal intensity on DWI and their cystic or necrotic areas had high ADC values (2.70+/-0.31 x 10(-3) mm(2)/s, mean ADCR=3.42). One fibrillary low-grade astrocytoma had a high DWI signal intensity and a low ADC value in its central cystic area (0.44 x 10(-3) mm(2)/s, ADCR=0.49). Postcontrast T1WIs yielded a sensitivity of 60%, a specificity of 27.27%, a positive predictive value (PPV) of 52.94%, and a negative predictive value (NPV) of 33.33% in the diagnosis of necrotic tumors. DWI yielded a sensitivity of 93.33%, a specificity of 90.91%, a PPV of 93.33%, and a NPV of 90.91%. The area under receiver operating characteristic (ROC) curves for postcontrast T1WI was 0.44 and DWI was 0.92. Analysis of these areas under the ROC curves indicates significant difference between postcontrast T1WI and DWI (P<.001). CONCLUSION: With some exceptions, DWI is useful in providing a greater degree of confidence in distinguishing brain abscesses from cystic or necrotic brain tumors than conventional MRI and seems to be a valuable diagnostic tool.

Brain↗
PubMed1994

Endoscopic stereotactic treatment of brain abscesses.

Treatment of brain abscess is still a subject of controversy. Craniotomy with primary extirpation and resection of the abscess membrane, burrhole craniotomy with puncture or insertion of a drain, marsupialization, or stereotactic aspiration are different therapeutic approaches. As a consequence of our experiences and results with neuro-endoscopic interventions we have introduced endoscopic stereotactic techniques in brain abscess treatment. Seven patients with brain abscesses were operated on stereotactically using an endoscope. In all cases the abscess contents were aspirated, while the abscess membrane was left in situ. The patients received postoperative antibiotic therapy according to microbial diagnosis. The longest follow-up period was 48 months. Six patients showed a marked improvement of neurological deficit after treatment. One patient died from sepsis caused by a bacterial endocarditis. The results emphasize that endoscopic stereotactic technique as a minimally invasive neurosurgical method can also be used for treatment of brain abscess.

Adult↗
PubMed1988

Current concepts in the pathogenesis and management of brain abscesses in children.

Brain abscesses represent the most frequent intracranial suppurative process occurring in children. Improved bacteriologic techniques for isolating anaerobic microorganisms have shown that anaerobes play a major role in brain abscesses in conjunction with aerobic organisms such as alpha-streptococci. Computerized tomography has improved the diagnosis of brain abscesses and has changed the management in certain circumstances. Although surgical drainage still remains the definitive treatment modality, conservative medical management with serial CT scans has been successful. Still, the mortality and morbidity of brain abscesses remain substantial.

Brain Abscess↗
PubMed1991

Otogenic brain abscess in childhood.

Brain abscesses are quite rare complications of middle ear infections. Although temporal lobe abscesses are more common than cerebellar abscesses, the converse was found to be true in our series of 10 cases. Eight cases of cerebellar abscess and 2 cases of temporal lobe abscess in the paediatric age group were reported including 4 cases of latent brain abscesses which manifested themselves after mastoidectomy for middle ear infection. Brain abscess is by far the most serious of otogenic complications.

Adolescent↗
PubMed2002

Multiple tuberculous brain abscesses.

Multiple tuberculous brain abscesses are rare. This report presents a female patient with a rapidly deteriorating clinical course. Computed tomographic scanning revealed multiple brain abscesses. Aspiration of one of the lesions yielded pus and positive acid-fast stained bacilli. The pathogenesis of multiple tuberculous brain abscesses is discussed.

Adult↗
PubMed1975

[A clinical survey of brain abscess (3rd report): special reference to chronological analysis of EEG on brain abscess (author's transl)].

The attention of those concerned with the management of intracranial abscess has been largely directed to a study of the findings in clinicopathological and neuroradiological investigations. Our object, in this communication is to arouse interest in the electroencephalographic survey, especially chronological electroencephalographic study of absecess patients. The clinical material forming the basis of this study is drawn from a series of 46 consecutive cases of intracranial abscess treated, during 3 years, in the neurosurgical department of Tokyo Women's Medical College.

Adolescent↗
PubMed1992

Brain abscess in infants.

Brain abscesses are rare in infants and their clinical presentation is specific for this age group. Seven cases of brain abscess in infants aged 2-11 months are reported. The underlying cause was meningitis in four, sepsis in two, and unknown in one. Gram-negative organisms were cultured in 6 patients. The abscess size was 5 cm or more in five cases; in four there were multiple lesions. Two abscesses were aspirated and irrigated; four particularly large lesions were drained and repeatedly aspirated and irrigated. One craniotomy was done. There were two deaths, one in the postoperative period and the other 6 months after discharge. Follow-up information is available for four children, showing a good result in only one of them. Formation of an abscess should be diagnosed early, and close ultrasound monitoring or CT scanning in infants with bacterial meningitis and sepsis is essential. The prognosis in cases in which large/multiple abscesses develop is poor.

Brain Abscess↗
PubMedDate not supplied

Home antibiotic therapy for brain abscesses.

Patients with brain abscesses now have the option of receiving intravenous antibiotic therapy at home. However, before discharge from the hospital, these patients require significant education in aseptic technique, general catheter care, medication administration, and troubleshooting. Also provided is a review of the pathology, signs, symptoms, diagnosis, and treatment of adult brain abscesses.

Anti-Bacterial Agents↗
PubMed2002

Surgical treatment of nocardial brain abscesses.

OBJECTIVE: Nocardial brain abscesses are associated with significant morbidity and mortality rates. The optimal management remains unclear. We reviewed the surgical outcomes of patients treated with a relatively uniform policy at a single institution. METHODS: Eleven patients were treated at the Royal Adelaide Hospital between 1970 and 2001. Their clinical presentations, surgical treatment, and outcomes were reviewed. RESULTS: Clinical presentations most frequently involved focal neurological deficits (91%). Predisposing factors were identified for 63% of the patients. Nine patients were treated only with aspiration and long-term chemotherapy. Two patients underwent craniotomy and lesion excision. The majority of patients required either one or two procedures. There were no deaths in this series. Management complications were observed for three patients. Abscess aspiration was complicated by parenchymal hemorrhage and ventriculitis for one patient and temporary worsening of hemiparesis for two patients. CONCLUSION: Our results suggest that aspiration alone (repeated as clinically indicated) is a safe, efficacious treatment for the majority of patients with nocardial brain abscesses.

Adult↗