Management of brain abscesses: a case report

Abstract

Abscesses and empyemas are frequent intracranial lesions, constituting a diagnostic and therapeutic emergency. We report the clinical, paraclinical and therapeutic aspects of these intracranial suppurations observed in one case in our department of the University Hospital Center Mustapha Bacha, Algiers.

The analysis focused on clinical aspects: Glasgow coma scale (GCS), presence of neurological deficit, brain imaging with contrast and the search for a portal of entry.

Treatment included surgery and antibiotic therapy, and prognosis assessed in the medium term. The portal of entry was ear, nose and throat (ENT) origin in 45%. Trepan puncture performed in 34% of cases in emergency with consciousness disorders or the removal of the shell in 16% of cases faced with the persistence or recurrence of the collection.

The good long-term prognostic factors were age, a GCS greater than12 on admission, and trepanning puncture followed by removal of the shell, appropriate antibiotic therapy and the treatment of the portal of entry.

Keywords: Brain abscess, intracranial empyema, Surgery, Complication