Brain abscess. Review of 89 cases over a period of 30 years

Abstract

Eighty-nine cases of brain abscess, diagnosed over a period of 30 years, are reviewed. The incidence of this disease did not decline throughout the period. Abscesses of ear and nose origin constituted the largest group (38%). Postoperative abscesses seem to have increased in incidence, presumably due to routine postoperative antibiotic treatment. Antibiotics were possibly responsible for the suppression of signs of infection in 45% of the patients, who presented as suffering from a space-occupying lesion. The most accurate diagnostic tool was angiography, which localized the lesion in 90% and suggested its nature in 61%. Brain scan may prove as satisfactory. Staphylococcus was cultured in about two-thirds of the cases. Mortality seemed to decrease concomitantly with the advent of more potent antibiotics. The treatment of choice in terms of both mortality and morbidity seemed to be enucleation after previous sterilization. The hazards of radical surgery should be taken into consideration.