Brain abscess

1,770 views

Published on

0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,770
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
119
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Brain abscess

  1. 1. Cerebral abscess • Epidemiology Pathogenesis Histogenesis Microbiology Clinical diagnosis Radiological evaluation Management Follow-up radiography Complications Prognosis
  2. 2. Epidemiology• Main factor• Incidence• Predisposing factor(otitis.sinusitis.OHI.CHD)• M/F 2-3/1
  3. 3. pathogenesis• Contiguous suppurative• Hematogenous• Dural opening• Immunosuppression• None
  4. 4. Histogenesis1. Early cerebritis2. Late cerebritis3. Early capsule formation4. Late capsule formation
  5. 5. Microbiology• Anaerobes %50• S.aureus %20-30• Gram negatives• Others
  6. 6. Clinical diagnosis• History• Symptom&sign• -headache• -focal neurological deficits• -seizure• -fever• -meningismus• -papilledema• -suddenly deterioration• LAB test
  7. 7. Radiological evaluation•CT scan•MRI
  8. 8. management• Nonoperative• Operative• -aspiration• -excision
  9. 9. nonoperative• Antibiotic• -sinusitis&otitis----aerobe&anaerobic• Post traumatic---- S.aureus&epidermis..VANCOMYCINE• Newborn---gramnegative(cyterobacter)…
  10. 10. Only AntiBiotic1- Uncontrolled bleeding diathesis2- Multiple abscess small than 1.5 CM in a neurologically intact with a clear source of infection.
  11. 11. management• Nonoperative• Operative• -aspiration• -excision
  12. 12. aspiration• Deep• Eloquent• multiple
  13. 13. Excision• Foreign body• CSF leakage• Fungal• Cerebellar abscess
  14. 14. Multiple abscess• Size above 2.5 cm• Size below 2.5cm
  15. 15. Duration of AB• Nonoperative…6-8 week• Operative• -aspiration…4-6 week• -excision…2-4 week• AIDS…1 year
  16. 16. 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.
  17. 17. roleOnly in life threatening condition (mass effect)
  18. 18. Complicatio• Herniation n• Rupture to ventricle & SAS
  19. 19. 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
  20. 20. Spinal abscess• Epidural• Subdural• Intramedullary
  21. 21. • 54-80% S.aureus• 8-15% stereptococcus• 5-8% mix• 4% no growth
  22. 22. Spinal epidural abscess• Sign&symptom• Imaging• -radionuclide scan• -myelography• -CT• -MRI
  23. 23. Symptom&sign• Back pain & fever the most common• Classically• 1-backache• 2-root pain• 3-extremity weakness• 4-bowel & bladder symptom• ESR^
  24. 24. Spinal epidural abscess• Sign&symptom• Imaging• -radionuclide scan• -myelography• -CT• -MRI
  25. 25. treatment• Medical• Surgical
  26. 26. medical• Very extensive• Without severe loss of neural function• Complete paralysis lasting more than 3 days
  27. 27. Spinal abscess• Epidural• Subdural• Intramedullary
  28. 28. Clinical signs & symptom• The same as epidural abscess
  29. 29. Spinal abscess• Epidural• Subdural• Intramedullary
  30. 30. Thank you

×