[Management of brain abscesses in era of computed tomography in sub-Saharan Africa: a review of 112 cases]

Neurochirurgie. 2014 Oct;60(5):249-53. doi: 10.1016/j.neuchi.2014.06.011. Epub 2014 Sep 20.
[Article in French]

Abstract

Patients and method: The authors report a retrospective study conducted on 112 cases of cerebral abscesses collected over a period of 12 years from the medical records of the department of neurosurgery at the Yalgado Ouedraogo university teaching hospital, Ouagadougou-Burkina Faso.

Results: The analyses were conducted on the epidemiological, clinical and prognostic aspects of the cases. The mean age of the patients (73 men and 39 women) was 26 years. The primary mode of infection ranged from cranial injuries (25%) to meningitis (17.9%) and sinusitis (15.2%). Bacteria were isolated from 16.1% cases; staphylococci and streptococci were the most frequent bacteria identified. The main clinical symptoms were motor deficit (75.9%), fever (74.1%) and headache (66.1%). Diagnosis was performed by CT scan in all cases. Fifty-three patients were treated using antibiotics alone; this medical treatment was completed by surgery in 59 cases. The results showed that 37.5% of the patients in fact fully recovered while some sequelae were identified in 49.1%. The mortality rate was 13.4%.

Discussion and conclusion: Consciousness disorders were in most cases responsible for the patient's death. Moreover multiple and/or voluminous abscesses were factors of the poor functional prognosis. Due to the high mortality rate and the frequency of sequelae, the authors emphasize the need of prevention by using adequate and sufficient antibiotics during primary infections.

Keywords: Abcès du cerveau; Brain abscess; Cerebral computed tomography; Prognosis; Pronostic; Tomodensitométrie cérébrale; Traitement; Treatment.

Publication types

  • Review

MeSH terms

  • Adult
  • Africa South of the Sahara
  • Anti-Bacterial Agents / therapeutic use
  • Brain Abscess / diagnostic imaging*
  • Brain Abscess / epidemiology
  • Brain Abscess / microbiology
  • Brain Abscess / therapy
  • Female
  • Humans
  • Male
  • Meningitis / drug therapy
  • Meningitis / epidemiology
  • Meningitis / prevention & control
  • Prognosis
  • Radiography
  • Retrospective Studies
  • Tomography Scanners, X-Ray Computed*

Substances

  • Anti-Bacterial Agents