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Year : 2020  |  Volume : 5  |  Issue : 3  |  Page : 311-315

Evaluation of stereotaxy in the management of brain abscess

Department of Neurosurgery, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Mostafa M Kashef
Department of Neurosurgery, Faculty of Medicine, Assiut University, Assiut
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCMRP.JCMRP_10_20

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Background Stereotaxic surgery began in 1908, when Sir Victor Horsley and Robert Clarke introduced their apparatus. Brain abscess (BA) is a life-threatening condition and has different modalities of treatment. One of these modalities is stereotactic aspiration. Aim The aim of the study was to evaluate and demonstrate the outcome of stereotactic-guided aspiration of BA. Patients and methods This is a prospective, descriptive study that included 20 patients with different intracranial abscesses aspirated by stereotaxy. Inclusion criteria: deep-seated abscesses that are located near or within eloquent structures. Multiple BAs differ in size with the largest one with mass effect. Compromised patients with poor general condition are considered to be poor candidates for open surgery. Exclusion criteria: all patients who will need surgical excision due to any cause such as posterior fossa abscess, large superficial BA close to the cortical surface. The authors did computerized tomography scan with contrast for all patients preoperatively, within the first 72 h postoperatively and after 6 months. Results The authors aspirated BAs from 20 patients of whom 14 were men. Most of these patients had single abscess (n=17). The most common presenting symptom is headache which is found in 16 patients. The most common sites for abscesses were brain stem and basal ganglia in half of the patients. The only complication found postoperatively was hemorrhage in only two patients. Only two (about 10%) cases showed residual abscess in 6 months follow-up. Conclusion The authors found that stereotaxy is very helpful in the cases with localization of the abscess, reducing morbidity and mortality of the cases, leading to save the resources.

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