title: Stereotactic surgery in the management of brain abscess.
abstract: BACKGROUND
  Bacterial brain abscesses can be diagnosed and treated with stereotactic aspiration.
  
  
  METHODS
  From 1991 to 1997 we have used computed tomography-guided stereotactic aspiration to diagnose and treat 21 patients with a total of 58 bacterial brain abscesses. The ages of the patients ranged from 4 to 72 years (median 25 years); 11 of these 21 patients had multiple abscesses. The number of abscesses per patient with multiple abscesses ranged from 2 to 9, all located deep in subcortical white matter.
  
  
  RESULTS
  All patients underwent stereotactic surgical drainage and an 8-week intravenous antibiotic medical treatment. Of the 58 abscesses, 23 were aspirated. Of these 23 abscesses, 19 were radiologically stage III or IV and four were stage I or II. Pathological examination confirmed radiological staging in 19 patients (83%). Except for the three patients who have mild residual hemiparesis and one patient recovering from ataxia, all patients had complete neurological recovery.
  
  
  CONCLUSIONS
  Computed tomography-guided stereotaxy achieved all the objectives of management; namely, ascertaining the diagnosis, draining the content of the mass, and obtaining pus for accurate bacteriological diagnosis without morbidity. Stereotactic aspiration combined with an 8-week intravenous antibiotic regimen has yielded an effective therapeutic result in all of our abscesses, small or large, solitary or multiple, superficial or deep-seated. A high radiological-pathological correlation was also deduced from this study.
authors.affiliation: Department of Neurosurgery, Istanbul Faculty of Medicine, University of Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Barlas
authors.forename: A
authors.initials: A
authors.lastname: Sencer
authors.forename: K
authors.initials: K
authors.lastname: Erkan
authors.forename: H
authors.initials: H
authors.lastname: Eraksoy
authors.forename: S
authors.initials: S
authors.lastname: Sencer
authors.forename: C
authors.initials: C
authors.lastname: Bayindir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed