MANAGEMENT OF SUPRATENTORIAL BRAIN ABSCESS

Objectives: To analyze the management out come of symptomatic supratentorial brain abscess by burr hole aspiration. Material and Methods: This descriptive study with 40 cases of symptomatic unilocular supratentorial pyogenic brain abscess was conducted at Department of Neurosurgery, Hayatabad Medical Complex, Peshawar from February 2006 to January 2008. Patients having history of headache for more than 14 days and diagnosed with contrast enhanced CT scan were included in the study. All patients were continued on antibiotic and were followed weekly for 1st month then monthly till the CT brain showed abscess resolution or no response to treatment was found. The data was recorded and analyzed using SPSS version13.0. Result: The longest diameter on preoperative CT scan was measured in all patients, which ranged from 2.3cm to 4.1cm, with a mean of 3.39cm + 0.5. Male to female ratio was 2:1 and mean age was 12.6 + 9.7. Out of 40 patients, 13(32.5%) patients required aspiration only once, 18 (45%) required twice and 9 (22.5%) patients for three times. All patients were followed for period of 3 to 7 months; the mean follow up period was 4.4 months + 1.033. The treatment was successful in 95% patients as only two patients (5%) did not show any response to treatment and required further excision. Conclusion: Burr hole aspiration is a reasonably good method to treat symptomatic unilocular supratentorial brain abscess that is larger than 2cm.