Brain abscess surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Abscess Main Page
Brain abscess Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Brain abscess from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Brain abscess surgery On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Brain abscess surgery All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Brain abscess surgery
CDC on Brain abscess surgery
Brain abscess surgery in the news
Blogs on Brain abscess surgery
Directions to Hospitals Treating Brain abscess
Risk calculators and risk factors for Brain abscess surgery

Overview

Surgery is the mainstay of treatment for patients with brain abscesses if the size of the abscess exceed 2.5 cm in diameter. The decision to drain the tumor surgically vs. aspiration is based on the number of abscesses, their size, and their location in the brain. Sterotactic aspiration of the brain abscess is performed for identifying causative pathogens and decompressions in the abscne of contraindications.

Surgery

• The decision to drain the tumor surgically vs. aspiration is based:

Size of Abscess

• Smaller than 2.5 cm in diameter: Administer antimicrobial therapy only.
• Larger than 2.5 cm in diameter: Drain (either surgically or by repeated aspirations) and administer antimicrobial therapy.

Number of Abscesses

• Single brain abscess: A single brain abscess less than 2.5 cm in diameter are usually aspirated for culture and are not surgically drained.
• Multiple brain abscesses: Repeated aspirations of multiple brain abscesses is preferred over surgical drainage.

Location of Abscesses

• Regions of sensory or motor cortex: Aspiration is preferred over surgical drainage.
• Speech region: Aspiration is preferred over surgical drainage.
• Other regions: Either aspiration or surgical drainage.

With contemporary neurosurgical techniques, almost any brain abscess greater than 1 cm in diameter is amenable to aspiration regardless of location. Regardless of the approach to drain the abscess, administration of long-term antimicrobial therapy is always recommended among all patients who are suspected to have brain abscess. To view the list antimicrobial regimens, click here.