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Brain abscess
- 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.
- 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- Uncontrolledbleeding 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 • Sizeabove 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 lifethreatening condition (mass effect)
- 30. Complicatio • Herniation n • Rupture to ventricle & SAS
- 31. Prognosis • The mostprognostic 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.
- 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.