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PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS

PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS. Agrawal D., Mahapatra A.K., Suri A. Department Of Neurosurgery, All India Institute Of medical Sciences, New Delhi-29. PROFILE OF BRAIN ABSCESSES. EPIDEMIOLOGY TOTAL OF 89 PTS. (JAN.99 - SEP.01) 67 PEDIATRIC

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PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS

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  1. PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS Agrawal D., Mahapatra A.K., Suri A. Department Of Neurosurgery, All India Institute Of medical Sciences, New Delhi-29

  2. PROFILE OF BRAIN ABSCESSES • EPIDEMIOLOGY TOTAL OF 89 PTS. (JAN.99 - SEP.01) 67 PEDIATRIC 11 (16%) FEMALE 56 (84%) MALE

  3. PROFILE OF BRAIN ABSCESSES • PRESENTING SIGNS ALTERED SENSORIUM – 19 (28%) CRANIAL NERVE PALSIES VII – 9 (13%) VI – 5 (7.5%) HEMIPARESIS – 14 (21%) NO DEFICITS – 20 (30%)

  4. PROFILE OF BRAIN ABSCESSES • LOCATION SUPRATENTORIAL – 52 (78%) INFRATENTORIAL – 15 (22%)

  5. PROFILE OF BRAIN ABSCESSES • ETIOLOGY CYANOTIC HEART DISEASE – 21 (31%) CSOM – 14 (21%) TUBERCULAR – 11 (16%) INFECTED DERMOID – 5 (7.5%) NEONATAL MENINGITIS – 8 (12%) UNKNOWN – 8 (12%)

  6. PROFILE OF BRAIN ABSCESSES • CAUSATIVE ORGANISM MSSA – 9 (13%) STREP. VIRIDANS – 3 (4.5%) CITROBACTER – 2 (3%) MRSA – 1 (1.5%) ACID FAST BACILLI – 1 (1.5%) FALCIPARUM MALARIA – 1 (1.5%) NO ORGANISM ISOLATED – 51 (76%)

  7. PROFILE OF BRAIN ABSCESSES • MANAGEMENT A TOTAL OF 85 BURR HOLE ASPIRATIONS AND 29 ABSCESS EXCISIONS WERE DONE IN 67 PATIENTS

  8. PROFILE OF BRAIN ABSCESSES • MANAGEMENT (contd.) 23 (34%) PATIENTS – 2 OR MORE ASPIRATIONS 10 (15%) PATIENTS – PRIMARY EXCISION 19 (28%) PATIENTS – EXCISION FOLLOWING ASPIRATION

  9. PROFILE OF BRAIN ABSCESSES • MANAGEMENT (CONTD.) PRIMARY MODALITY OF TREATMENT INFRATENTORIAL ABSCESSES– EXCISION SUPRATENTORIAL ABSCESSES - BURR HOLE ASPIRATION

  10. PROFILE OF BRAIN ABSCESSES BASAL GANGLIA ABSCESS PRE TAPPING POST TAPPING

  11. PROFILE OF BRAIN ABSCESSES POSTERIOR FOSSA ABSCESS SUB DURA EMPYMA

  12. PROFILE OF BRAIN ABSCESSES • HOSPITAL STAY AVERAGE HOSPITAL STAY – 12 DAYS MINIMUM STAY – 4 DAYS MAXIMUIM STAY – 32 DAYS

  13. PROFILE OF BRAIN ABSCESSES • FOLLOW UP AVAILABLE FOR 51 (76%) PATIENTS AVERAGE FOLLOW UP 5.6 MONTHS (RANGE 1 MONTH – 24 MONTHS)

  14. PROFILE OF BRAIN ABSCESSES • SEQUELAE 14 (21%) - HYDROCEPHALUS 4 PATIENTS REQUIRED SHUNT PLACEMENT 7 (10%) – SEIZURES 2 (3%) – DIED (BOTH HAD SUBDURAL EMPYMA)

  15. PROFILE OF BRAIN ABSCESSES SEQUELAE

  16. PROFILE OF BRAIN ABSCESSES • CONCLUSIONS • We prefer primary excision of abscess in Infratentorial compartment and Aspiration in other regions. • Tuberculosis should be strongly suspected in all cases and searched for.

  17. PROFILE OF BRAIN ABSCESSES • CONCLUSIONS (Contd.) • Hydrocephalus can develop in a number of successfully treated patients(21%in our series), though only a small percentage will require shunt placement.

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