Brain abscess natural history, complications and prognosis

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

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Complications

Mortality is currently quoted to range from 0 – 24%.

• Poor prognostic indicators include:
• Intraventricular rupture:

• 80% mortality rate, often treated with open drainage and debridement f/b ventriculostomy catheter for drainage and intrathecal abx

• Mental status and neurologic function at time of Dx:

• The most common sequellae is seizures, which develop in 35 – 70% of patients.

Prognosis

Early detection and treatment of the disease affects the overall health and prognosis on brain abscesses. Before the introduction of CT scans, the prognosis for brain abscesses was low. Since the 1960s, there has been a large improvement in detecting the disease due to improved ability to image the head, better neurosurgical techniques, and better antibiotic treatments. If the abscess if treated before a patient undergoes a coma, the death rate decreases from 20% to 5%.