PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS Agrawal D., Mahapatra A.K., Suri A. Department Of Neurosurgery, All India Institute Of medical.

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PROFILE OF BRAIN ABSCESSES IN PEDIATRIC POPULATION AT AIIMS Agrawal D., Mahapatra A.K., Suri A. Department Of Neurosurgery, All India Institute Of medical Sciences, New Delhi-29

PROFILE OF BRAIN ABSCESSES EPIDEMIOLOGY EPIDEMIOLOGY TOTAL OF 89 PTS. (JAN.99 - SEP.01) 67 PEDIATRIC 11 (16%) FEMALE 56 (84%) MALE

PROFILE OF BRAIN ABSCESSES PRESENTING SIGNS PRESENTING SIGNS ALTERED SENSORIUM – 19 (28%) CRANIAL NERVE PALSIES VII – 9 (13%) VI – 5 (7.5%) HEMIPARESIS – 14 (21%) NO DEFICITS – 20 (30%)

PROFILE OF BRAIN ABSCESSES LOCATION LOCATION SUPRATENTORIAL – 52 (78%) INFRATENTORIAL – 15 (22%)

PROFILE OF BRAIN ABSCESSES ETIOLOGY ETIOLOGY CYANOTIC HEART DISEASE – 21 (31%) CSOM – 14 (21%) TUBERCULAR – 11 (16%) INFECTED DERMOID – 5 (7.5%) NEONATAL MENINGITIS – 8 (12%) UNKNOWN – 8 (12%)

PROFILE OF BRAIN ABSCESSES CAUSATIVE ORGANISM CAUSATIVE ORGANISM MSSA – 9 (13%) STREP. VIRIDANS – 3 (4.5%) CITROBACTER – 2 (3%) MRSA – 1 (1.5%) ACID FAST BACILLI – 1 (1.5%) FALCIPARUM MALARIA – 1 (1.5%) NO ORGANISM ISOLATED – 51 (76%)

PROFILE OF BRAIN ABSCESSES MANAGEMENT MANAGEMENT A TOTAL OF 85 BURR HOLE ASPIRATIONS AND 29 ABSCESS EXCISIONS WERE DONE IN 67 PATIENTS

PROFILE OF BRAIN ABSCESSES MANAGEMENT (contd.) MANAGEMENT (contd.) 23 (34%) PATIENTS – 2 OR MORE ASPIRATIONS 10 (15%) PATIENTS – PRIMARY EXCISION 19 (28%) PATIENTS – EXCISION FOLLOWING ASPIRATION

PROFILE OF BRAIN ABSCESSES MANAGEMENT (CONTD.) MANAGEMENT (CONTD.) PRIMARY MODALITY OF TREATMENT INFRATENTORIAL ABSCESSES– EXCISION SUPRATENTORIAL ABSCESSES - BURR HOLE ASPIRATION

PROFILE OF BRAIN ABSCESSES PRE TAPPINGPOST TAPPING BASAL GANGLIA ABSCESS

PROFILE OF BRAIN ABSCESSES POSTERIOR FOSSA ABSCESSSUB DURA EMPYMA

PROFILE OF BRAIN ABSCESSES HOSPITAL STAY HOSPITAL STAY AVERAGE HOSPITAL STAY – 12 DAYS MINIMUM STAY – 4 DAYS MAXIMUIM STAY – 32 DAYS

PROFILE OF BRAIN ABSCESSES FOLLOW UP FOLLOW UP AVAILABLE FOR 51 (76%) PATIENTS AVERAGE FOLLOW UP 5.6 MONTHS (RANGE 1 MONTH – 24 MONTHS)

PROFILE OF BRAIN ABSCESSES SEQUELAE SEQUELAE 14 (21%) - HYDROCEPHALUS 14 (21%) - HYDROCEPHALUS 4 PATIENTS REQUIRED SHUNT PLACEMENT 7 (10%) – SEIZURES 7 (10%) – SEIZURES 2 (3%) – DIED 2 (3%) – DIED (BOTH HAD SUBDURAL EMPYMA)

PROFILE OF BRAIN ABSCESSES SEQUELAE

PROFILE OF BRAIN ABSCESSES CONCLUSIONS CONCLUSIONS - We prefer primary excision of abscess in Infratentorial compartment and Aspiration in other regions. - Tuberculosis should be strongly suspected in all cases and searched for.

- Hydrocephalus can develop in a number of successfully treated patients(21%in our series), though only a small percentage will require shunt placement. PROFILE OF BRAIN ABSCESSES CONCLUSIONS (Contd.) CONCLUSIONS (Contd.)