title: Minimally invasive image-guided keyhole aspiration of cerebral abscesses.
abstract: Despite the low incidence of brain abscesses in Western nations (1-2%), the incidence in developing countries is as high as 8%. We evaluate a minimally invasive image-guided keyhole aspiration of cerebral abscesses and compare it with a series of cases treated with surgical excision. 23 patients (20 male and 3 female, aged 7-67 years) underwent image-guided burr hole aspiration of single or multiple cerebral abscesses. Patient characteristics, perioperative, and postoperative data were analyzed and compared with a second group of 22 patients (14 male and 8 female, aged 12-72) treated for cerebral abscesses with open surgical excision. In all cases, the surgical procedure was performed successfully without complication. 8 of the 23 aspiration cases were performed with the aid of iMRI. A comparison of patient demographics, duration of hospital stay, duration of antibiotic therapy, postoperative neurological recovery time, intraoperative blood loss, operative duration, length of incision, postoperative fever, repeat surgery, and mortality was performed between the aspiration and excision groups. Intraoperative blood loss, operative duration, length of incision, and postoperative fever were all significantly reduced in the aspiration group. Though, duration of hospital stay and antibiotic therapy and postoperative neurological recovery time were all increased in the aspiration group, and statistical significance was observed in all except the duration of hospital stay. This technique is a feasible and comparable minimally invasive alternative to open surgical excision and may provide reduced intraoperative blood loss, shortened operative duration, improved cosmetic outcomes, and a lessened incidence of postoperative fever.
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Xiang-Hui
authors.initials: XH
authors.lastname: Meng
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Shi-Yu
authors.initials: SY
authors.lastname: Feng
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Jiashu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Fuyu
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Bu
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital Beijing 100853, China.
authors.forename: Xin-Guang
authors.initials: XG
authors.lastname: Yu
keywords: Brain abscess; aspiration; burr hole; drainage; minimally invasive; neuronavigation