Clinical Features of Brain Abscess in Addition to Dental Infection Presenting to Neurosurgery Department at Rehman Medical Institute Peshawar Pakistan

Background: Brain abscess is one of the serious life menacing infections of the brain parenchyma. The mortality rate from brain abscess is approximately 10%, however, if the abscess ruptures into the ventricular system, the mortality rate may increase to 80%. Brain abscess is a serious infection through different sources in addition to dental infection as well, which must be diagnosed early and treated aggressively. We planned to determine the clinical presentation of patients with brain abscess. The clinical features include signs and symptoms of raised intracranial pressure, focal neurological sign and meningesumus, however, there could be a variation in the clinical presentation which was the primary aim of this study. Objective: To determine the clinical presentation of brain abscess in addition to dental infection presenting to Neurosurgery Department at Rehman Medical Institute Peshawar Pakistan. Materials and Methods: This prospective descriptive case series was done at the Department of Neurosurgery, Rehman Medical Institute Peshawar Pakistan. A total of 43 patients were enrolled in a study period of three years from January 2012 to December 2015. All patients operated in neurosurgery department who were diagnosed to have brain abscess were included in the study and those who were treated medically were excluded from the study. The study outcome was to observe the clinical presentation. Results: The mean+SD age of study patients was 26.7 + 15.5 years ranging from 1 to 68 years. Male gender was in dominance (65.1%). The most frequent observed clinical symptoms were vomiting in 24 (55.8%) of patients, severe headache in 18 (41.8%) while 14 32.5%) had a mild or moderate headache while 11 (25.5%) patients each had fever and fits. Out of total 43 cases, 3 (7.0%) had GCS up to 5, 7 (16.2%) had GCS between 6 and 10 while 16 (37.2%) of patients had GCS 11 or above. Conclusion: It is concluded on the basis of our results that brain abscess can be managed successfully provided a timely presentation, diagnosis, and initiation of treatment. Most of the clinical data was in continuation with previously reported evidence.