Cerebral abscess on Merseyside 1980–1988

doi:10.1016/0163-4453(92)93989-4

Journal of Infection

Volume 25, Issue 2, September 1992, Pages 163-172

https://doi.org/10.1016/0163-4453(92)93989-4 Get rights and content

Summary

We report a retrospective study of 62 patients presenting to The Walton Centre for Neurology and Neurosurgery with cerebral abscess in the 8-year period between 1980 and 1988. The study shows that while the incidence of cerebral abscess has not altered from the previous decade, aetiological factors have changed and major developments in the diagnosis and management of the condition have resulted in a marked reduction in the morbidity and mortality associated with brain abscess.

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Central nervous system abscesses and empyemas in England: epidemiological trends over five decades
2023, Journal of Infection
To report on population-based epidemiological trends in central nervous system (CNS) abscesses and empyemas in England over five decades.
Trend analyses of age-sex-specific hospital admission and death rates using routinely collected English national hospital discharge records, mortality records, and annual population denominators from 1968 to 2019.
Hospital admission rates for CNS abscesses and empyemas were stable in England until the late 1980s. In the last two decades of the study period (1999–2019), first-time admissions increased from 1.24 per 100,000 population in 1999 (95% confidence interval [CI] 1.14-1.35) to 2.86 in 2019 (95% CI 2.72–3.01). Admission rates were highest among infants and older adults, and were higher for males than females. There were small but significant increases in annual mortality rates for CNS abscesses and empyemas over the last two decades of the study period after accounting for population ageing, but mortality remained low at around 0.1–0.2 per 100,000 population. Mortality increased with advancing age; deaths in childhood were extremely rare. Case fatality rates where a relevant diagnosis was recorded as either the underlying or contributing cause were 4.3% and 9.7% respectively.
The increase in CNS abscesses and empyemas in England might reflect improved case ascertainment, but the likelihood of a true rise in incidence should be considered.
Novel approach to the treatment of a cerebral abscess using the Apollo vibration/suction device
2018, Journal of Clinical Neuroscience
Citation Excerpt :
The prevalence of brain abscesses is reported to be 1 per 100,000, with an overall mortality of 36%–90% [1]. More recent advances in neuroimaging along with advances in antibiotics have reduced mortality to 0%–24% [2–4]. The most common sites of brain abscesses are the temporal lobes (42%) followed by the cerebellum (30%) [5].
Intracerebral abscess is a very serious condition associated with significant morbidity and mortality. This article describes a novel treatment for a cerebral abscess, using the Penumbra Apollo suction/vibration aspiration system (Penumbra, Almeda, CA, USA). This article represents the first reported case of the device’s use for treatment of an intracerebral abscess.
The patient discussed presented to the emergency department in critical condition, and was found to be suffering from a right thalamic cerebral abscess. She underwent treatment with both medical management and surgical intervention with the use of the Apollo system.
This report details a novel technique for surgical abscess drainage with an excellent clinical outcome. The aim is to provide insight into the treatment of intracerebral abscesses, the utility of the Apollo system, and the device’s application beyond intracerebral and intraventricular hemorrhage.
Brain Abscess and Other Focal Pyogenic Infections of the Central Nervous System
2017, Infectious Diseases, 2-Volume Set
Brain abscess and other focal pyogenic infections of the central nervous system
2010, Infectious Diseases: Third Edition
Brain and Spinal Cord Abscess
2003, Neurological Disorders: Course and Treatment: Second Edition
This chapter presents a discussion on the clinical aspects of the brain and spinal cord abscess. Brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Brain abscesses can be classified according to the route of infection—contiguous spread of an adjacent infection, hematogenous seeding from a distant focus, and direct inoculation of pathogens or facilitation of their entry into the brain by trauma or neurosurgical procedures. Frequent contiguous infections predisposing for brain abscess are otitis media or mastoiditis and paranasal sinusitis. Infrequent causative adjacent infections are those of the teeth, the skull, or the scalp. Very rarely, a brain abscess can result from an infection within the subarachnoid space. The site of the primary infectious focus often determines the location of the abscess. Thus, otogenic abscesses are frequently located in the cerebellum or temporal lobe. Abscesses due to paranasal sinusitis or odontogenic infections are often located in the frontal lobe. The discussion on principles of therapy includes surgery of brain abscess, medical therapy, which includes antibiotics, anticonvulsants, and corticosteroids. The chapter also discusses prophylaxis of brain abscess, subdural empyema, epidural abscess, spinal epidural abscess, and others.
Brain abscess
2014, Infections of the Central Nervous System: Fourth Edition

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Original articleCerebral abscess on Merseyside 1980–1988

Summary

J Infect

Three decades of brain abscess in Merseyside

J R Coll Surg Edinb

Decreased mortality from brain abscesses since the advent of computerized tomography

J Neurosurg

Value of computed tomography in the diagnosis of intracranial abscess

J Neurol Neurosurg Psychiatry

Experience with 88 consecutive cases of brain abscess

J Neurosurg

Brain abscesses in Northern Ireland: A 30 year community review

J Neurol Neurosurg Psychiatry

Brain abscess: A review of 400 cases

J Neurosurg

Cerebellar abscess: A review of 47 cases

J Neurol Neurosurg Psychiatry

Trends in the management of bacterial brain abscesses: A review of 102 cases over 17 years

Neurosurgery

Brain abscess and cerebritis

Rev Infect Dis

Original article
Cerebral abscess on Merseyside 1980–1988