title: Treatment outcome of superficial cerebral abscess: an analysis of two surgical methods.
abstract: BACKGROUND
  The purpose of the study is to compare the two surgical methods (burr hole and craniotomy) used as treatment for superficial cerebral abscess and its outcome in terms of radiological clearance on brain CT, improvement of neurological status, the need for repeated surgery, and survival and morbidity at three months after surgery. This report is a retrospective case review of the patients who were treated surgically for superficial cerebral abscess in Hospital Kuala Lumpur (HKL) and Hospital Sultanah Aminah (HSA) over a period of four years (2004 to 2007).
  
  
  METHODS
  Fifty-one cases were included in this study: 64.7% of patients were male and 35.5% were female. Most of the patients were Malay (70.6%); 28 patients (54.9%) had undergone craniotomy and excision of abscess, and the rest had undergone burr hole aspiration as their first surgical treatment.
  
  
  RESULTS
  This study reveals that patients who had undergone craniotomy and excision of abscess showed a significantly earlier improvement in neurological function, better radiological clearance and lower rate of re-surgery as compared to the burr hole aspiration group (P<0.05). However, with respect to neurological improvement at 3 months, morbidity and mortality, there is no significant difference between the two surgical methods.
  
  
  CONCLUSIONS
  The significance of these findings can only be confirmed by a prospective randomised series. Further study will be required to assess the cost effectiveness, intensive care needs, and possibility of shorter antibiotic usage as compared to burr hole aspiration.
authors.affiliation: Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Jln Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Wei Ming
authors.initials: WM
authors.lastname: Tan
authors.forename: Johari Siregar
authors.initials: JS
authors.lastname: Adnan
authors.forename: Mohamad Saffari
authors.initials: MS
authors.lastname: Mohamad Haspani