Long-term neurological residua in patients surviving brain abscess with surgery

Abstract

✓ Long-term neurological sequelae were analyzed in 40 patients (24 adults and 16 children) who survived a brain abscess with surgery. Median follow-up was 6 years. The brain abscesses were secondary to hematogenous spread, sinus and mastoid infections, and trauma. Hemiparesis, seizures, visual defects, and learning problems (in children) were the most common sequelae observed. Abscess location played a significant role in determining sequelae. Only two of 16 patients with frontal polar and temporal lobe abscesses had unsatisfactory long-term results, while eight of 16 individuals with abscesses near the sensorimotor strip were left with permanent unsatisfactory neurological sequelae. Nineteen of 24 adults (80%) had a satisfactory long-term neurological status, but only 10 of 16 children (63%) had a similar outcome. In adult survivors, hemiparesis and seizures were mild, and emotional changes rare. Children were often severely paretic, had poorly controlled seizures, suffered from personality impairment, and were occasionally totally disabled. If the postoperative neurological condition is used to evaluate various types of surgical therapy for the treatment of brain abscess, then the therapies under study must be matched for patient age and abscess location before treatment comparisons can be made.