[Cerebral abscesses in children treated by puncture. A 16 year-experience]

Abstract

In the last 16 years, 33 children have been treated for brain abscesses. Fifteen (45.5%) presented with cyanogenic congenital heart disease; eleven (33.5%) with E.N.T. infection. The standardized treatment protocol included puncture of the abscess, antibiotherapy and anti-edematous drugs. Postoperative permanent epidural ICP monitoring and, in the last 6 years, repeated CT scans indicated when it was necessary to tap the abscess again or to reinforce the anti-edematous treatment. However, in 3 of these 33 cases, the abscess had to be removed. Postoperative mortality rate was 3%. Overall mortality rate was 6%. Neurological sequelae were slight. Epilepsy occurred in 10%. Mental retardation (16%) was only found in children with cyanogenic congenital heart diseases. Repeated CT scans showed the progressive disappearance, within a few months, of the abscess membranes. This study shows an improvement in the results when brain abscesses in children are punctured rather than excised.