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Pyogenic-Cerebral (Brain) Abscess

Tshetiz Dahal

Abstract


Abscesses in the brain have been one of the most challenging wounds, both for surgeons and trainees. It is a packet full of pus of infected material in the part of the brain. It is an important neurological disease and can produce deadly diseases. Since the beginning of the era of computed tomography (CT), the diagnosis and treatment of these organizations has become simpler and less invasive. The results have been improved with the development of diagnostic techniques, neurosurgery, and comprehensive antibiotics. Rare bacterial abscesses are usually caused by the use of chemicals in oncology, longevity in patients infected with human immunodeficiency virus (HIV), and immunosuppression associated with organ transplants. Surgical treatment options did not show significant differences in mortality rates, but lower rates of illness were achieved with a stereo-guided curiosity. Eager stereo-directed antidepressant, antibiotic-based treatment based on the effects of culture culture, and repeated desires expressed in the results of periodic CT scans appear to be the most appropriate treatment for brain tumors. Immunosuppression and comorbidities, early neurological conditions, and intraventricular fractures were important factors influencing patient outcomes. Traps and mutations in the diagnosis and treatment of brain tumors have been discussed in this study.

 


Keywords


Abscess, Abscess in brain, Effect, Stereotaxy, Treatments

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References


Agarwal AK, Garg R, Simon M: Ring enhancing lesion on CT scan: metastases or a brain abscess? Emerg Med J 24(10):706, 2007

Alderson PO, Gado MH, Siegel BA: Computerized cranial tomography and radionuclide imaging in the detection of intracranial mass lesions. Semin Nucl Med 7(2):161–173, 1977

Ashdown BC, Tien RD, Felsberg GJ: Aspergillosis of the brain and paranasal sinuses in immuno compromised patients: CT and MR imaging findings. AJR Am J Neuroradiol 162(1):155–159, 1994

Baldwin AC, Kielian T: Persistent immune activation associated with a mouse model of Staphylococcus aureus-induced experimental brain abscess. J Neuroimmunol 151(1-2):24–32, 2004

Barlas O, Sencer A, Erkan K, Eraksoy H, Sencer S, Bayindir C: Stereotactic surgery in the management of brain abscess. Surg Neurol 52(4):404–411, 1999

Barsoum AH, Lewis HC, Cannillo KL: Nonoperative treatment of multiple brain abscesses. Surg Neurol 16(4):283–287, 1981

Beller AJ, Sahar A, Praiss I: Brain abscess. Review of 89 cases over a period of 30 years. J Neurol Neurosurg Psychiatry 36(5):757–768, 1973

Black P, Graybill JR, Charache P: Penetration of brain abscess by systemically administered antibiotics. J Neurosurg 38(6):705–709, 1973

Black PM, Levine BW, Picard EH, Nirmel K: Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. Surg Neurol 19(6):524–527, 1983

Boom WH, Tuazon CU: Successful treatment of multiple brain abscesses with antibiotics alone. Rev Infect Dis 7(2):189–199, 1985

Brewer NS, MacCarty CS, Wellman WE: Brain abscess: a review of recent experience. Ann Intern Med 82(4):571–576, 1975

Britt RH, Enzmann DR, Placone RC Jr, Obana WG, Yeager AS: Experimental anaerobic brain abscess. Computerized tomographic and neuropathological correlations. J Neurosurg 60(6):1148– 1159, 1984

Burtscher IM, Holtås S: In vivo proton MR spectroscopy of untreated and treated brain abscesses. AJNR Am J Neuroradiol 20(6):1049–1053, 1999

Calfee DP, Wispelwey B: Brain abscess. Semin Neurol 20(3): 353–360, 2000

Canale DJ: William Macewen and the treatment of brain abscesses: revisited after one hundred years.

J Neurosurg 84(1):133–142, 1996

Cansever T, Izgi N, Civelek E, Aydoseli A, Kiris T, Sencer A: Retrospective analysis of changes in diagnosis, treatment and prognosis of brain abscess for a period of thirty-three-years, in 13th World Congress of Neurological Surgery, Marrakesh, June 19–24, 2005. Nyon Vaud, Switzerland: World Federation of Neurosurgical Societies, 2005 (Abstract)

Carey ME, Chou SN, French LA: Experience with brain abscesses. J Neurosurg 36(1):1–9, 1972

Carpenter J, Stapleton S, Holliman R: Retrospective analysis of 49 cases of brain abscess and review of the literature. Eur J Clin Microbiol Infect Dis 26(1):1–11, 2007

Chun CH, Johnson JD, Hofstetter M, Raff MJ: Brain abscess. A study of 45 consecutive cases. Medicine (Baltimore) 65(6):415– 431, 1986

Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M: Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses. AJNR Am J Neuroradiol 20(7):1252–1257 1999

Dyste GN, Hitchon PW, Menezes AH, VanGilder JC, Greene GM: Stereotaxic surgery in the treatment of multiple brain abscesses. J Neurosurg 69(2):188–194, 1988

Ebeling U, Hasdemir MG: Stereotactic guided microsurgery of cerebral lesions. Minim Invasive Neurosurg 38(1):10–15, 1995

Enzmann DR, Britt RH, Lyons BE: Brain abscess. Neurosurgery 16:877–878, 1985

Enzmann DR, Britt RH, Placone RC Jr, Obana W, Lyons B, Yeager AS: The effect of short-term corticosteroid treatment on the CT appearance of experimental brain abscesses. Radiology 145(1):79–84, 1982

Epstein NE, Hollingsworth R, Black K, Farmer P: Fungal brain abscesses (aspergillosis/mucormycosis) in two immunosuppressed patients. Surg Neurol 35(4):286–289, 1991

Erdogan E, Beyzadeoglu M, Arpaci F, Celasun B: Cerebellar aspergillosis: case report and literature review. Neurosurgery 50(4): 874–877, 2002

Erdogan E, Gönül E, Seber N: Craniocerebral gunshot wounds. Neurosurg Q 12(4):1–18, 2002

Erdogan E, Izci Y, Gonul E, Timurkaynak E: Ventricular injury following cranial gunshot wounds: clinical study. Mil Med 169(9):691–695, 2004

Everett ED, Strausbaugh LJ: Antimicrobial agents and the central nervous system. Neurosurgery 6(6):691–714, 1980

Fritsch M, Manwaring KH: Endoscopic treatment of brain abscess in children. Minim Invasive Neurosurg 40(3):103–106, 1997

Gaches J, Lebeau J, Daum S, Waks O: [Study of epileptic sequelae in a series of 20 brain abscesses followed up for more than 10 years.] Neurochirurgie 11:441–452, 1965 (Fr)

Garvey G: Current concepts of bacterial infections of the central nervous system. Bacterial meningitis and bacterial brain abscess. J Neurosurg 59(5):735–744, 1983

Gillet GR, Garner JE, Bremner DA: Antimicrobial management of intracranial abscess. Aust N Z J Surg 54(3):253–255, 1984

Goodkin HP, Harper MB, Pomeroy SL: Intracerebral abscess in children: historical trends at Children’s Hospital Boston. Pediatrics 113(6):1765–1770, 2004

Gönül E, Baysefer A, Kahraman S, Ciklatekerlioglu O, Gezen F, Yayla O, et al: Causes of infections and management results in penetrating craniocerebral injuries. Neurosurg Rev 20:177–181, 1997

Gortvai P, De Louvois J, Hurley R: The bacteriology and chemotherapy of acute pyogenic brain abscess. Br J Neurosurg 1(2):189–203, 1987

Greenberg MS: Handbook of Neurosurgery, ed 5. New York: Thieme, 2001, pp 217–223

Gupta RK, Nath K, Prasad A, Prasad KN, Husain M, Rathore RK, et al: In vivo demonstration of neuro inflammatory molecule expression in brain abscess with diffusion tensor imaging. AJNR Am J Neuroradiol 29(2):236–332, 2008

Guzman R, Barth A, Lövblad KO, El-Koussy M, Weis J, Schroth G, et al: Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors. J Neurosurg 97(5):1101–1107, 2002

Haimes AB, Zimmerman RD, Morgello S, Weingarten K, Becker RD, Jennis R, et al: MR imaging of brain abscesses. AJR Am J Roentgenol 152(5):1073–1085, 1989

Hakan T, Ceran N, Erdem I, Berkman MZ, Göktas¸ P: Bacterial brain abscesses: an evaluation of 96 cases. J Infect 52(5):359–366, 2006

Hellwig D, Bauer BL, Dauch WA: Endoscopic stereotactic treatment of brain abscesses. Acta Neurochir Suppl (Wien) 61:102– 105, 1994

Hirschberg H, Bosnes V: C-reactive protein levels in the differential diagnosis of brain abscesses. J Neurosurg 67(3):358–360, 1987

Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy: The rational use of antibiotics in the treatment of brain abscess. Br J Neurosurg 14(6):525–530, 2000

Jamjoom AB: Short course antimicrobial therapy in intracranial abscess. Acta Neurochir (Wien) 138(7):835–839, 1996

Jennett B, Miller JD: Infection after depressed fracture of skull. Implications for management of nonmissile injuries. J Neurosurg 36(3):333–339, 1972

Kagawa M, Takeshita M, Yato S, Kitamura K: Brain abscess in congenital cyanotic heart disease. J Neurosurg 58(6):913–917, 1983

Kamikawa S, Inui A, Miyake S, Kobayashi N, Kasuga M, Yamadori T, et al: Neuro-endoscopic surgery for brain abscess. Eur J Paediatr Neurol 1:121–122, 1997

Kao PT, Tseng HK, Liu CP, Su SC, Lee CM: Brain abscess: clinical analysis of 53 cases. J Microbiol Immunol Infect 36(2): 129–136, 2003

Karampekios S, Hesselink J: Cerebral infections. Eur Radiol 15(3): 485–493, 2005

Karasu A, Cansever T, Sabancı PA, Kiris T, Imer M, Oran E, et al: [Craniocerebral civilian gunshot wounds: one hospital’s experience.] Ulus Travma Acil Cerrahi Derg 14(1):59–64, 2008

Kielian T: Immuno pathogenesis of brain abscess. J Neuro inflamm 1(1):16, 2004

Kielian T, Esen N, Bearden ED: Toll-like receptor 2 (TLR2) is pivotal for recognition of S. aureus peptidoglycan but not intact bacteria by microglia. Glia 49(4):567–576, 2005

Kielian T, Esen N, Liu S, Phulwani NK, Syed MM, Phillips N, et al: Minocycline modulates neuroinflammation independently of its antimicrobial activity in staphylococcus aureus-induced brain abscess. Am J Pathol 171(4):1199–1214, 2007

Kondziolka D, Duma CM, Lunsford LD: Factors that enhance the likelihood of successful stereotactic treatment of brain abscesses. Acta Neurochir (Wien) 127(1-2):85–90, 1994

Kutlay M, Colak A, Yildiz S, Demircan N, Akin ON: Stereotactic aspiration and antibiotic treatment combined with hyperbaric oxygen therapy in the management of bacterial brain abscesses. Neurosurgery 57(6):1140–1146, 2005

Lai PH, Li KT, Hsu SS, Hsiao CC, Yip CW, Ding S, et al: Pyogenic brain abscess: findings from in vivo 1.5-t and 11.7-t in vitro proton MR spectroscopy. AJNR Am J Neuroradiol 26(2):279–288, 2005

Le Moal G, Landron C, Grollier G, Bataille B, Roblot F, Nassans P, et al: Characteristics of brain abscess with isolation of anaerobic bacteria. Scand J Infect Dis 35(5):318–321, 2003

Lee TH, Chang WN, Su TM, Chang HW, Lui CC, Ho JT, et al: Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses. J Neurol Neurosurg Psychiatry 78(3):303–309, 2007

Leys D, Christiaens JL, Derambure P, Hladky JP, Lesoin F, Rousseaux M, et al: Management of focal intracranial infections: is medical treatment better than surgery? J Neurol Neurosurg Psychiatry 53(6):472–475, 1990

Longatti P, Perin A, Ettorre F, Fiorindi A, Baratto V: Endoscopic treatment of brain abscesses. Childs Nerv Syst 22(11):1447–1450, 2006

Lu CH, Chang WN, Lui CC: Strategies for the management of bacterial brain abscess. J Clin Neurosci 13(10):979–985, 2006

Lunsford LD: Stereotactic drainage of brain abscesses. J Neurosurg .1987 Dec;9(4):270-4.

Mamelak AN, Mampalam TJ, Obana WG, Rosenblum ML: Improved management of multiple brain abscesses: a combined surgical and medical approach. Neurosurgery 36(1): 76–86, 1995

Mampalam TJ, Rosenblum ML: Trends in the management of bacterial brain abscesses: a review of 102 cases over 17 years. Neurosurgery 23(4):451–458, 1988

Mathisen GE, Johnson JP: Brain abscess. Clin Infect Dis 25(4):763–779, 1997

Morgan H, Wood MW, Murphey F: Experience with 88 consecutive cases of brain abscess. J Neurosurg 38(6):698–704, 1973

Nadkarni T, Goel A: Aspergilloma of the brain: an overview. J Postgrad Med 51 (Suppl 1): S37–S41, 2005

Ng A, Gadong N, Kelsey A, Denning DW, Leggate J, Eden OB: Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia. Pediatr Hematol Oncol 17(6): 497–504, 2000

Ng PY, Seow WT, Ong PL: Brain abscesses: review of 30 cases treated with surgery. Aust N Z J Surg 65(9):664–666, 1995

Nunez DA: Aetiological role of otolaryngological disease in paediatric intracranial abscess. J R Coll Surg Edinb 37(2):80–82, 1992

Nunez DA, Browning GG: Risks of developing an otogenic intracranial abscess. J Laryngol Otol 104(6):468–472, 1990

Ohaegbulam SC, Saddeqi NU: Experience with brain abscesses treated by simple aspiration. Surg Neurol 13(4):289–291, 1980

Osenbach RK, Loftus CM: Diagnosis and management of brain abscess. Neurosurg Clin N Am 3(2):403–420, 1992

Osma U, Cureoglu S, Hosoglu S: The complications of chronic otitis media: report of 93 cases. J Laryngol Otol 114(2):97–100, 2000

Pit S, Jamal F, Cheah FK: Microbiology of cerebral abscess: a four-year study in Malaysia. J Trop Med Hyg 9(3)6:191–196, 1993

Quartey GR, Johnston JA, Rozdilsky B: Decadron in the treatment of cerebral abscess. An experimental study. J Neurosurg 45(3): 301–310, 1976

Qureshi HU, Habib AA, Siddiqui AA, Mozaffar T, Sarwari AR: Predictors of mortality in brain abscess. J Pak Med Assoc 52(3): 111–116, 2002

Roche M, Humphreys H, Smyth E, Phillips J, Cunney R, Mc Namara E, et al: A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect 9(8):803–809, 2003

Rosenblum ML, Mampalam TJ, Pons VG: Controversies in the management of brain abscesses. Clin Neurosurg 33:603–632, 1986

Rosenfeld EA, Rowley AH: Infectious intracranial complications of sinusitis, other than meningitis, in children: 12-year review. Clin Infect Dis 18(5):750–754, 1994

Salzman C, Tuazon CU: Value of the ring-enhancing sign in differentiating Intracerebral hematomas and brain abscesses. Arch Intern Med 147(5):951–952, 1987

Sandrock D, Verheggen R, Helwig AT, Munz DL, Markakis E, Emrich D: Immunoscintigraphy for the detection of brain abscesses. Nucl Med Commun 17:311–316, 1996

Schliamser SE, Bäckman K, Norrby SR: Intracranial abscesses in adults: an analysis of 54 consecutive cases. Scand J Infect Dis 20(1):1–9, 1988

Schroeder KA, McKeever PE, Schaberg DR, Hoff JT: Effect of dexamethasone on experimental brain abscess. J Neurosurg 66(2):264–269, 1987

Schroeder PC, Post MJ, Oschatz E, Stadler A, Bruce-Gregorios J, Thurnher MM: Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma. Neuroradiology 48(10):715–720, 2006

Sennaroglu L, Sozeri B: Otogenic brain abscess: review of 41 cases. Otolaryngol Head Neck Surg 123(6):751–755, 2000

Seydoux C, Francioli P: Bacterial brain abscesses: factors influencing mortality and sequelae. Clin Infect Dis 15(3):394–401, 1992

Sharma BS, Banerjee AK, Sobti MK, Kak VK: Actinomycotic brain abscess. Clin Neurol Neurosurg 92(4):373–376, 1990

Sharma BS, Gupta SK, Khosla VK: Current concepts in the management of pyogenic brain abscess. Neurol India 48(2):105–111, 2000

Smith RR: Neuroradiology of intracranial infection. Pediatr Neurosurg 18(2):92–104, 1992

Stapleton SR, Bell BA, Uttley D: Stereotactic aspiration of brain abscesses: is this the treatment of choice? Acta Neurochir (Wien) 121(1-2):15–19, 1993

Stephanov S, Joubert MJ: Large brain abscesses treated by aspiration alone. Surg Neurol 17(5):338–340, 1982

Takeshita M, Kagawa M, Izawa M, Takakura K: Current treatment strategies and factors influencing outcome in patients with bacterial brain abscess. Acta Neurochir (Wien) 140(12):1263– 1270, 1998

Takeshita M, Kagawa M, Yato S, Izawa M, Onda H, Takakura K, et al: Current treatment of brain abscess in patients with congenital cyanotic heart disease.Neurosurgery 41(6):1270–1279, 1997

Tekkök IH, Erbengi A: Management of brain abscess in children: review of 130 cases over a period of 21 years. Childs Nerv Syst 8(7):411–416, 1992

Tsai JC, Teng LJ, Hsueh PR: Direct detection of bacterial pathogens in brain abscesses by polymerase chain reaction amplification and sequencing of partial 16S ribosomal deoxyribonucleic acid fragments. Neurosurgery 55(5):1154–1162, 2004

Tseng JH, Tseng MY: Brain abscess in 142 patients: factors influencing outcome and mortality. Surg Neurol 65(6):557–562, 2006

Van Alphen HA, Dreissen JJ: Brain abscess and subdural empyema. Factors influencing mortality and results of various surgical techniques. J Neurol Neurosurg Psychiatry 39:481– 490, 1976

Vogelsang JP, Wehe A, Markakis E: Postoperative intracranial abscess—clinical aspects in the differential diagnosis to early recurrence of malignant glioma. Clin Neurol Neurosurg 100(1): 11–14, 1998

Whelan MA, Hilal SK: Computed tomography as a guide in the diagnosis and follow-up of brain abscesses. Radiology 135(5): 663–671, 1980

Wise BL, Gleason CA: CT-directed stereotactic surgery in the management of brain abscess. Ann Neurol 6(5):457, 1979

Xiao F, Tseng MY, Teng LJ, Tseng HM, Tsai JC: Brain abscess: clinical experience and analysis of prognostic factors. Surg Neurol 63(5):442–450, 2005

Yang SY: Brain abscess: a review of 400 cases. J Neurosurg 55(5):794–799, 1981

Yang SY, Zhao CS: Review of 140 patients with brain abscess. Surg Neurol 39(4):290–296, 1993

Young JD, McGwire BS: Infliximab and reactivation of cerebral toxoplasmosis. N Engl J Med 353(14):1530–1531, 2005

Zeidman SM, Geisler FH, Olivi A: Intraventricular rupture of a purulent brain abscess: case report. Neurosurgery 36(1):189–193, 1995




DOI: https://doi.org/10.37591/rrjon.v12i1.2844

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