2. Cerebral abscess
• Epidemiology
Pathogenesis
Histogenesis
Microbiology
Clinical diagnosis
Radiological evaluation
Management
Follow-up
radiography
Complications
Prognosis

3. Epidemiology
• Main factor
• Incidence
• Predisposing
factor(otitis.sinusitis.OHI.CHD)
• M/F 2-3/1

4. pathogenesis
• Contiguous suppurative
• Hematogenous
• Dural opening
• Immunosuppression
• None

7. Histogenesis
1. Early cerebritis
2. Late cerebritis
3. Early capsule formation
4. Late capsule formation

15. Microbiology
• Anaerobes %50
• S.aureus %20-30
• Gram negatives
• Others

16. Clinical diagnosis
• History
• Symptom&sign
• -headache
• -focal neurological deficits
• -seizure
• -fever
• -meningismus
• -papilledema
• -suddenly deterioration
• LAB test

17. Radiological evaluation
•CT scan
•MRI

18. management
• Nonoperative
• Operative
• -aspiration
• -excision

19. nonoperative
• Antibiotic
• -sinusitis&otitis----aerobe&anaerobic
• Post traumatic----
S.aureus&epidermis..VANCOMYCINE
• Newborn---gramnegative(cyterobacter)…

20. Only AntiBiotic
1- Uncontrolled bleeding diathesis
2- Multiple abscess small than 1.5
CM in a neurologically intact with a
clear source of infection.

21. management
• Nonoperative
• Operative
• -aspiration
• -excision

22. aspiration
• Deep
• Eloquent
• multiple

23. Excision
• Foreign body
• CSF leakage
• Fungal
• Cerebellar abscess

24. Multiple abscess
• Size above 2.5 cm
• Size below 2.5cm

26. Duration of AB
• Nonoperative…6-8 week
• Operative
• -aspiration…4-6 week
• -excision…2-4 week
• AIDS…1 year

27. Radiological follow-
up
• CT weekly during treatment.
• CT 1 week afterward.
• CT 1 mount then bimonthly…
RESOLVED.
• CT entity 2-3 w.after treatment.
• Mass effect resolved after 3-4 month.
• Contrast in CT until 6-9month.

29. role
Only in life threatening
condition
(mass effect)

30. Complicatio
• Herniation
n
• Rupture to ventricle & SAS

31. Prognosis
• The most prognostic factor:
• Neurological condition
• -mortality…60% in herniation
• -coma…89%
• -general…0-21%
• Neurological sequelae:
• 1-focal neurological deficite
• 2-cognitive impairment
• 3-seizure

41. Spinal abscess
• Epidural
• Subdural
• Intramedullary

42. • 54-80% S.aureus
• 8-15%
stereptococcus
• 5-8% mix
• 4% no growth

43. Spinal epidural abscess
• Sign&symptom
• Imaging
• -radionuclide scan
• -myelography
• -CT
• -MRI

44. Symptom&sign
• Back pain & fever the most common
• Classically
• 1-backache
• 2-root pain
• 3-extremity weakness
• 4-bowel & bladder symptom
• ESR^

45. Spinal epidural abscess
• Sign&symptom
• Imaging
• -radionuclide scan
• -myelography
• -CT
• -MRI

46. treatment
• Medical
• Surgical

47. medical
• Very extensive
• Without severe loss of neural function
• Complete paralysis lasting more than 3
days

48. Spinal abscess
• Epidural
• Subdural
• Intramedullary

49. Clinical signs & symptom
• The same as epidural abscess

50. Spinal abscess
• Epidural
• Subdural
• Intramedullary

51. Thank
you