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Volume 12 Issue 4 ( October-December ) 2023

Original Articles

Evaluation of Two Surgical Methods for Treatment of Superficial Cerebral Abscess and Its Outcome at a Tertiary Care Centre
Pankaj Kumar, Jayendra Kumar

Background: Brain abscess is a serious infection which can be metastasis of chronic suppurative diseases or a congenital cardiomyopathy, from an open head injury or from neurosurgical procedures, but they are more frequently seen in healthy adults suffering from chronic sinusitis or otitis. The present study was conducted to analyse two surgical methods used for treatment for superficial cerebral abscess and its outcome. Materials and Methods: The present study was a retrospective study in which patients who were treated surgically for superficial cerebral abscess over a period of two years were included. In this study, all the patients who had undergone the burr hole procedure and pus aspiration are categorised in the “burr hole” group and patients who had undergone craniotomy or craniectomy and excision of the abscess with its capsule were categorised in the same “craniotomy” group. In this study the neurological status of the patients was assessed preoperatively and postoperatively. Data was collected and analysed. Results: In this study 53.75% patients were males, and 46.25% patients were females. Mean age of patients was 38.7years. Altered sensorium was the most common clinical presentation among brain abscess patients (83.75%) The range of duration of symptoms prior to admission was mostly less than a week (57.5%). Based on the CT brain, the most common location for the abscess is the frontal region in 38 patients (47.5%). Out of 80 cases, 47.5% had undergone burr hole aspiration as their first surgical treatment and 52.5% cases had undergone craniotomy and excision of the abscess. In burr hole aspiration cases more patients shows improvement of neurological status at one weekand 3 months than craniotomy excision. In burr hole aspiration cases 25% patients shows satisfactory radiological clearancewhereas in craniotomy excision, 48.75% patients shows satisfactory radiological clearance. In burr hole aspiration cases 26.25% patients needed repeat surgerywhereas in craniotomy excision, 2.5% patients needed repeat surgery. Conclusion: The present study concluded that patients who had undergone craniotomy and excision of abscess showed a significantly earlier improvement in neurological function, better radiological clearance and lower rate of re-surgery as compared to the burr hole aspiration group.

 
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