Clinical profile of brain abscesses: ten-year retrospective single-center study

Abstract

Background: Brain abscess is a rare clinical entity of neurosurgery with poor outcomes. In this study, we aimed to develop clinical profiles of the cases of brain abscesses presented at Chitwan Medical College by reviewing hospital records.   Methods: The hospital-based retrospective study includes 18 patients presented from April 2013 to April 2023 diagnosed with brain abscess. Data regarding their demographic profile and other factors were collected in well-structured proforma from hospital records, OT records, and ICU records of the neurosurgery department of Chitwan medical college teaching hospital. Data were analysed using SPSS software using frequencies, proportions, and means functions.   Results: In our study, we reported 18 cases of brain abscess with a mean age of 24.6 years having male to female ratio of 3.5:1. Fever, headache, and focal neurological deficit (classic triad of brain abscess) were present in 16.67 % of the cases. The most common presenting complaint was fever in 61.1 % following headache in 50% of cases. The commonly involved part of the brain was temporal lobe 27.8%. Primary focus of lesion was identifiable in ten cases with CSOM being the most common focus in 44.4% of the case. Consciousness was clear (GCS = 15) in five patients (27.7%), mildly disturbed (GCS = 13 or 14) in 16.7% , moderately disturbed (GCS = 9-12) in 44.5%, and severely disturbed or comatose (GCS = 3-8) in 11.11% of patients. 72.2 % of the cases were managed by craniotomy and evacuation, 11.1% by burr hole and evacuation whereas 16.7% denied any form of treatment.   Conclusion: The advancement of imaging techniques and the use of IV antibiotics has exponentially improved outcome of the brain abscesses. Furthermore, with CSOM being the most common contagious focus, multidisciplinary management of the cases with brain abscess will benefit the patient.