Management of focal intracranial infections: is medical treatment better than surgery?
Three groups of patients with single hemispheric brain abscesses or subdural empyemas, from 1 to 5 cm large, with similar initial prognosis, have been treated either by medical treatment alone (20), aspiration (21), or excision (15). Differences in survival were not found, but medical treatment alone was better for long term sequelae. Surgical procedures (either aspiration or excision) were better for both isolation of the organism and the hospital stay before discharge. In spite of good results, it is unwise to conclude too strongly in favour of no surgical treatment as this study was not randomised.
Leys
D
D
Department of Neurology, University of Lille, France.
Christiaens
J L
JL
Derambure
P
P
Hladky
J P
JP
Lesoin
F
F
Rousseaux
M
M
Jomin
M
M
Petit
H
H
D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001922:Brain Abscess / Q000188:drug therapy / Q000601:surgery*; D002423:Cause of Death; D002443:Ceftriaxone / Q000008:administration & dosage; D003131:Combined Modality Therapy; D013354:Empyema, Subdural / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D015366:Pefloxacin / Q000008:administration & dosage; D011183:Postoperative Complications / Q000401:mortality; D013396:Suction; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D015366:Pefloxacin; D002443:Ceftriaxone; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination