Brain abscess surgery

	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

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

Overview

Sterotactic aspiration of the brain abscess should be performed with the intention of identification of the causative pathogen and decompression in the absence of contraindications. An abscess measures at least 2.5 cm in diameter has been recommended as an indication for intervention; however, with contemporary neurosurgical techniques, almost any brain abscess greater than 1 cm in diameter is amenable to aspiration regardless of location.^[1]^[2]

Surgery

The decision to drain the tumor surgically vs. aspiration is based on the number of abscesses, their size, and their location in the brain.

=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 <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 Abscess

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.

References

↑ Brouwer, Matthijs C.; Tunkel, Allan R.; McKhann, Guy M.; van de Beek, Diederik (2014-07-31). "Brain abscess". The New England Journal of Medicine. 371 (5): 447–456. doi:10.1056/NEJMra1301635. ISSN 1533-4406. PMID 25075836.
↑ Mamelak, A. N.; Mampalam, T. J.; Obana, W. G.; Rosenblum, M. L. (1995-01). "Improved management of multiple brain abscesses: a combined surgical and medical approach". Neurosurgery. 36 (1): 76–85, discussion 85-86. ISSN 0148-396X. PMID 7708172. Check date values in: |date= (help)

[1] Brouwer, Matthijs C.; Tunkel, Allan R.; McKhann, Guy M.; van de Beek, Diederik (2014-07-31). "Brain abscess". The New England Journal of Medicine. 371 (5): 447–456. doi:10.1056/NEJMra1301635. ISSN 1533-4406. PMID 25075836.

[2] Mamelak, A. N.; Mampalam, T. J.; Obana, W. G.; Rosenblum, M. L. (1995-01). "Improved management of multiple brain abscesses: a combined surgical and medical approach". Neurosurgery. 36 (1): 76–85, discussion 85-86. ISSN 0148-396X. PMID 7708172. Check date values in: |date= (help)

[1]

[2]