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been shown recently. [50] Neuroendoscopic treatment, mortality was the neurologic condition of the patient
when compared to stereotactic aspiration, has an at the time of admission. Here, we found mortality
additional advantage of more complete drainage and was very high in brain abscess with low GCS score on
lavage. [51] admission [Tables 7 and 8]. Landriel et al. [39] revealed
that age, immunosuppression and hematogenous
Many authors recommended craniotomy and excision spread were all associated with poor outcomes.
for abscesses that enlarge after 2 weeks of antibiotic
therapy or that fail to shrink after 3-4 weeks of In conclusion, predisposing factors were seen in nearly
antibiotics. [1,6,7,45] Craniotomy is also recommended half of the cases. In most of the cases, pus culture did
for multiloculated abscesses and larger lesions with not yield causative organisms. From this series, we
significant mass effect that are superficial and located see that in “chronic abscess group” pyogenic abscess
in noneloquent regions of the brain. A few authors also were the commonest followed by tuberculus abscess
recommended excision of abscesses in the cerebellum, but possibilities of other causes (i.e. fungal) should
where recurrent pus collection following aspiration can not be overlooked. Mortality due to brain abscess
lead to precipitous neurological worsening. [26] There was not directly related to surgical intervention but
are certain advantages to excision of a brain abscess on admission GCS has a significant association with
in an otherwise neurologically intact patient. The the mortality. Like other diseases, we can state early
risk of repeated collection of pus is almost completely diagnosis and optimum follow-up, and timely surgical
eliminated, and hence the expense involved in repeated interventions are the keys in the management of brain
imaging is saved. The duration of hospitalization abscess.
is also reduced. Furthermore, in patients with an
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