Stereotactic aspiration and drainage of brain abscesses. Experience with 9 cases.
The first-line treatment for brain abscesses is still a much-debated argument. Recently, stereotactic aspiration of these lesions has gained ground as a valid alternative to the traditional medical and/or surgical therapeutical treatments. From 1991 to 1995, 9 patients affected by intracranial abscesses were surgically treated by stereotactic puncture of the lesion and drainage of pus, using the Kelly-Goerss stereotactic system. Multiple abscesses were present in one case. Specific antibiotic therapy was used in the post-operative stage, when possible. One death occurred four weeks after surgery for acute ischemia of the brain stem. Follow-up CT demonstrated gradual resolution of the abscesses in all the cases and a successful return to normal daily life in all the surviving patients. In one case, recurrence of the abscess occurred two months after resolution: a successful result was obtained by steroids and broad-spectrum antibiotic therapy alone. Possible advantages of this technique are discussed and compared with the traditional routes. The literature concerning this argument is reviewed.
Skrap
M
M
Divisione di Neurochirurgia, Ospedale di Cattinara, Trieste, Italy.
Melatini
A
A
Vassallo
A
A
Sidoti
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods; D002443:Ceftriaxone / Q000008:administration & dosage; D002511:Cephalosporins / Q000008:administration & dosage; D004322:Drainage / Q000379:methods*; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009428:Netilmicin / Q000008:administration & dosage; D010634:Phenobarbital / Q000008:administration & dosage; D011182:Postoperative Care; D012008:Recurrence; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D002511:Cephalosporins; D005839:Gentamicins; D009428:Netilmicin; D002443:Ceftriaxone; D010634:Phenobarbital