A Study on Brain Abscess

Suresh Babu, T (2013) A Study on Brain Abscess. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Brain abscess is defined as a focal, intra cerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Although rare in developed countries brain abscess still remains a significant health care problem in developing countries. Historically brain abscess was mentioned by Hippocrates in 460 BC and he himself has described the association of brain abscess with ear infection. The Brain is well protected from infections by a thick skull vault, tough duramater and important barriers like bloodbrain barrier and blood cerebrospinal fluid (CSF) barrier. A breach in any of these barriers leads to entry of microorganisms into the brain initiating a suppurative inflammation culminating in brain abscess. The inciting organism can be introduced from outside by trauma or endogenously from infection in a contiguous site eg. ear or occasionally blood borne, heart disease and systemic infection. Although the portal of entry of the organism is commonly identified, the organism remains obscure in 10 -37% of the patients. In the recent decades the addition of Computed tomography (CT) and Magnetic Resonance Imaging (MRI) to the diagnostic armamentarium has facilitated early identification and thereby prompt institution of therapy in brain abscess. Improved microbiological techniques have increased the appreciation of the bacteriological spectrum of brain abscess especially anaerobes. The advanced surgical techniques viz. stereotactic guided aspiration, real-time ultrasound imaging has caused a paradigm shift in the management and outcome of brain abscess. AIM OF THE STUDY: The aim is to study the epidemiology, clinical profile, management and outcome in patients with brain abscess. MATERIALS AND METHODS: All patients admitted in the Institute of Neurology, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai, between August 2010 and February 2013, with brain abscess was included in this study. Inclusion Criteria: All patients who have been diagnosed as having brain abscess were included in the study group. On admission patient’s clinical profile such as age, sex, presenting symptoms complete neurological examination, conscious level and signs were recorded. All patients were subjected to CT scan brain plain study. In CT of patients having brain abscess the following features were noted – location, number of abscess, loculation, associated hydrocephalus. Patients were either managed conservatively or by surgery. The specimen obtained by surgical means was subjected to microbiological study. All the data were entered in a proforma as shown in the appendix. Outcome analysis was done at the time of discharge. CONCLUSION: A study of 60 patients presenting with brain abscess has lead to the following conclusions. 1. Brain abscess still occurs in the modern era, better visualized with modern imaging studies. 2. Retro viral infections also contribute for brain abscess apart from other known causes, hence all cases of brain abscesses to be screened for retro viral infection. 3. Neonates and children show poor prognosis and prompt aggressive management is essential for better outcome. 4. Constant vigil and surveillance will help for decreasing the magnitude of morbidity and mortality from brain abscess.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Brain Abscess.
Subjects: MEDICAL > Neuro Surgery
Depositing User: Subramani R
Date Deposited: 12 Feb 2020 02:17
Last Modified: 12 Feb 2020 02:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/11917

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