Overview
Burr-Hole Aspiration For Abscess :
 |
Three cases of brain abscess caused by Actinomyces israelii are reported which were successfully treated by burr hole aspiration and a short course of antibiotics (3-4 weeks). The clinical response of the patients, as well as the serial serum C-reactive protein levels and CT findings were used as a guideline for stopping antimicrobial therapy relatively early. |
Material And Methods
The patients underwent surgery at two different institutions. Computed tomography scanning and magnetic resonance imaging were performed, along with diffusion-weighted imaging and in vivo proton magnetic resonance spectroscopy. The abscesses were drained via a transmastoid route.
Symptoms
Onset may be sudden or subacute over several weeks :
- Common presenting symptoms include fever, headache, changes in mental state (drowsiness, confusion), focal neurological deficits, grand-mal seizures, nausea and vomiting, neck stiffness.
- A suddenly worsening headache, followed by emerging signs of meningism is often associated with rupture of the abscess.
Signs
- Fever
- Focal motor or sensory deficits
- Raised blood pressure and bradycardia associated with raised intracranial pressure
- Papilloedema
- Ataxia
- Confusion, drowsiness
- Bulging fontanelle in infants
Complications
- Intracerebral abscesses may rupture into the ventricular system and produce ventriculitis.
- Epilepsy occurs in around 30%, particularly with temporal lobe abscess and subdural empyema. Anticonvulsants may be required.
- Mainly depending on the speed of diagnosis and treatment, 20-80% of survivors have neurological sequelae, e.g. hemiparesis, visual field loss.
For more information, medical assessment and medical quote
as email attachment to
Email : - info@wecareindia.com
Contact Center Tel. (+91) 9029304141 (10 am. To 8 pm. IST)
(Only for international patients seeking treatment in India)
Nephrotic Syndrome 
Hematuria 
Hemodialysis 
Coronary 
Fabry Disease 
Hypertension 
