Brain abscess in Iraq during a 10 years period: part 1. epidemiology, aetiology and clinical picture

This study comprises two parts, [this part deals with epidemiology, aetiology and clinical features of brain abscess during a 10 years period, while the second will deal with diagnostic investigation, management and final outcome of brain abscess. The case records of patients with brain abscess admitted to the neurosurgical specialties hospital in Baghdad over a 10 years period extending from 1[st] Jan. 1993 to 31[s] Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. A total of 78 cases [1.2% of total admission] of brain abscess were admitted. Their age ranged from one month to 68 years. The most common aetiological factor was cyanotic heart disease, with the congenital anomaly being unrepaired in all cases. Remote infection foci other than the heart represented minority. Half of the cases had a rapid onset and fluminant progression. The presenting features of the patients older than one year were raised intracranial pressure, and focal neurological deficit and infection. Maintaining a high index of clinical suspicions in patients having one of the infection sources together with neurological signs should be emphasized

Brain abscesses in Iraq during a 10 years period: Part 11. Diagnostic investigations, management -and outcome

This study comprises two parts, the first one dealt with epidemiology etiology and clinical picture of brain abscess. This part describes diagnostic investigation management and final outcome of brain abscess during a 10 years period. The case records of patients with brain abscess admitted to the neurosur, specialties hospital in Baghdad over a 10 years period extending from 1 "Jan. 1993 to 31 " Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. Results of peripheral leukocytes count, ESR and CSF were supportive in 16.7%, 67.9% 78% of cases in which tests were applied, respectively. CT scan was suggestive in 100% of cases. Use of antibiotic therapy as a preliminary treatment line was adopted in 37.8% cases, while surgery as a preliminary line of treatment was adopted in 62.3% of cases. Out 68 cases, complete resolution was encountered in 70.6% ol'cases, sequlae in 11.8% and death in 17.9%. Bad neurological 'status on admission was the most encountered contributing factor for death. Metastasis from a remote infection process is a risky aetiology contributing to bad prognosis. The use Of C I Scan represents all important change in the diagnostic regimen brain abscess in the last 10-15 years