PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS

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PROFILE OF BRAIN ABSCESSES IN PEDIATRIC
POPULATION AT AIIMS

• Agrawal D., Mahapatra A.K., Suri A.
• Department Of Neurosurgery, All India Institute
  Of medical Sciences, New Delhi-29

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PROFILE OF BRAIN ABSCESSES

• EPIDEMIOLOGY
• TOTAL OF 89 PTS. (JAN.99 - SEP.01)
• 67 PEDIATRIC
• 11 (16) FEMALE
• 56 (84) MALE

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PROFILE OF BRAIN ABSCESSES

• PRESENTING SIGNS
• ALTERED SENSORIUM 19 (28) CRANIAL NERVE
  PALSIES
• VII 9 (13)
• VI 5 (7.5)
• HEMIPARESIS 14 (21)
• NO DEFICITS 20 (30)

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PROFILE OF BRAIN ABSCESSES

• LOCATION
• SUPRATENTORIAL 52 (78)
• INFRATENTORIAL 15 (22)

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PROFILE OF BRAIN ABSCESSES

• ETIOLOGY
• CYANOTIC HEART DISEASE 21 (31)
• CSOM 14 (21)
• TUBERCULAR 11 (16)
• INFECTED DERMOID 5 (7.5)
• NEONATAL MENINGITIS 8 (12)
• UNKNOWN 8 (12)

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PROFILE OF BRAIN ABSCESSES

• CAUSATIVE ORGANISM
• MSSA 9 (13)
• STREP. VIRIDANS 3 (4.5)
• CITROBACTER 2 (3)
• MRSA 1 (1.5)
• ACID FAST BACILLI 1 (1.5)
• FALCIPARUM MALARIA 1 (1.5)
• NO ORGANISM ISOLATED 51 (76)

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PROFILE OF BRAIN ABSCESSES

• MANAGEMENT
• A TOTAL OF
• 85 BURR HOLE ASPIRATIONS AND
• 29 ABSCESS EXCISIONS WERE DONE IN 67 PATIENTS

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PROFILE OF BRAIN ABSCESSES

• MANAGEMENT (contd.)
• 23 (34) PATIENTS 2 OR MORE ASPIRATIONS
• 10 (15) PATIENTS PRIMARY EXCISION
• 19 (28) PATIENTS EXCISION FOLLOWING
  ASPIRATION

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PROFILE OF BRAIN ABSCESSES

• MANAGEMENT (CONTD.)
• PRIMARY MODALITY OF TREATMENT
• INFRATENTORIAL ABSCESSES EXCISION
• SUPRATENTORIAL ABSCESSES - BURR HOLE ASPIRATION

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PROFILE OF BRAIN ABSCESSES
BASAL GANGLIA ABSCESS
PRE TAPPING
POST TAPPING
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PROFILE OF BRAIN ABSCESSES
POSTERIOR FOSSA ABSCESS
SUB DURA EMPYMA
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PROFILE OF BRAIN ABSCESSES

• HOSPITAL STAY
• AVERAGE HOSPITAL STAY 12 DAYS
• MINIMUM STAY 4 DAYS
• MAXIMUIM STAY 32 DAYS

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PROFILE OF BRAIN ABSCESSES

• FOLLOW UP
• AVAILABLE FOR 51 (76) PATIENTS
• AVERAGE FOLLOW UP 5.6 MONTHS
• (RANGE 1 MONTH 24 MONTHS)

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PROFILE OF BRAIN ABSCESSES

• SEQUELAE
• 14 (21) - HYDROCEPHALUS
• 4 PATIENTS REQUIRED SHUNT PLACEMENT
• 7 (10) SEIZURES
• 2 (3) DIED
• (BOTH HAD SUBDURAL EMPYMA)

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PROFILE OF BRAIN ABSCESSES
SEQUELAE
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PROFILE OF BRAIN ABSCESSES

• CONCLUSIONS
• We prefer primary excision of abscess in
  Infratentorial compartment and Aspiration in
  other regions.
• Tuberculosis should be strongly suspected in all
  cases and searched for.

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PROFILE OF BRAIN ABSCESSES

• CONCLUSIONS (Contd.)

• Hydrocephalus can develop in a number of
  successfully treated patients(21in our series),
  though only a small percentage will require shunt
  placement.