Stereotactic aspiration and drainage of brain abscesses. Experience with 9 cases

Minim Invasive Neurosurg. 1996 Dec;39(4):108-12. doi: 10.1055/s-2008-1052228.

Abstract

The first-line treatment for brain abscesses is still a much-debated argument. Recently, stereotactic aspiration of these lesions has gained ground as a valid alternative to the traditional medical and/or surgical therapeutical treatments. From 1991 to 1995, 9 patients affected by intracranial abscesses were surgically treated by stereotactic puncture of the lesion and drainage of pus, using the Kelly-Goerss stereotactic system. Multiple abscesses were present in one case. Specific antibiotic therapy was used in the post-operative stage, when possible. One death occurred four weeks after surgery for acute ischemia of the brain stem. Follow-up CT demonstrated gradual resolution of the abscesses in all the cases and a successful return to normal daily life in all the surviving patients. In one case, recurrence of the abscess occurred two months after resolution: a successful result was obtained by steroids and broad-spectrum antibiotic therapy alone. Possible advantages of this technique are discussed and compared with the traditional routes. The literature concerning this argument is reviewed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / therapy*
  • Catheterization, Peripheral / instrumentation
  • Catheterization, Peripheral / methods
  • Ceftriaxone / administration & dosage
  • Cephalosporins / administration & dosage
  • Drainage / methods*
  • Drug Therapy, Combination / administration & dosage
  • Follow-Up Studies
  • Gentamicins / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Netilmicin / administration & dosage
  • Phenobarbital / administration & dosage
  • Postoperative Care
  • Recurrence
  • Stereotaxic Techniques*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Cephalosporins
  • Gentamicins
  • Netilmicin
  • Ceftriaxone
  • Phenobarbital