title: A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China.
abstract: BACKGROUND
  Brain abscesses continue to pose diagnostic and therapeutic challenges in developed and developing countries. Their aetiology and management remain complex and unclear, making improvement of treatments and outcome difficult.
  
  
  METHODS
  To determine the demographics, management, and the variables that affect the outcome in subjects with brain abscesses treated at a single centre over an 11-year period, we retrospectively analysed data in 60 patients with brain abscesses surgically treated with stereotactically guided aspiration or open craniotomy excision in Shanghai Changzheng Hospital between January 2001 and December 2011. Such variables as age, gender, Glasgow Coma Scale (GCS) score at admission, clinical presentation, location, number of lesions, predisposing factors, mechanism of infection, aetiological agent, and therapy were analysed independently.
  
  
  RESULTS
  Our analysis demonstrated that patient age and gender were factors that influence the occurrence of brain abscess; female patients and patients greater than 40 years of age were most likely to suffer a brain abscess. We also found that a patient's GCS score upon admission did not influence outcome. While frequency of successful culturing of the infectious agent was low, positive cultures were obtained in only 8 of the cases (13.33%), in which the most common isolate was Streptococcus milleri. Outcome was favourable in 78.33% of the subjects, while the mortality rate was 20%. The outcome of one patient was poor due to the abscess in the basal ganglia region.
  
  
  CONCLUSIONS
  Stereotactically guided aspiration is an effective treatment for brain abscess with an overall favourable outcome. Mortality due to brain abscess was not directly related to surgery nor surgical technique. Additional studies will continue to reveal patients trends that may improve treatment for brain abscess.
authors.forename: Chenran
authors.initials: C
authors.lastname: Zhang
authors.forename: Liuhua
authors.initials: L
authors.lastname: Hu
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Wu
authors.forename: Guohan
authors.initials: G
authors.lastname: Hu
authors.forename: Xuehua
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No, 415, Feng-Yang Road, Shanghai 200003, China. luyc305@163.com.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D002681:China; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D034364:Streptococcus milleri Group / Q000302:isolation & purification*; D013396:Suction / Q000379:methods; D016896:Treatment Outcome