Les abcès cérébraux (à propos de 80 cas)

• Published in: Neuro-chirurgie Vol. 55; no. 1; pp. 40 - 44
• Main Authors: Hilmani, S, Riyahi, S, Ibahioin, K, Naja, A, El Kamar, A, El Azhari, A
• Format: Journal Article
• Language: French
• Published: Paris Elsevier Masson SAS 01.02.2009; Masson
• Subjects: Abcès cérébraux; Brain abscess; Chirurgie (generalites). Transplantations, greffes d'organes et de tissus. Pathologie des greffons; Chirurgie du système nerveux; CT scan; Intracranial suppuration; Neurosurgery; Scanner cérébral; Sciences biologiques et medicales; Sciences medicales; Suppurations intracrâniennes; Surgery; Brain abscess; Intracranial suppuration; CT scan; Scanner cérébral; Abcès cérébraux; Suppurations intracrâniennes; Infection; Pathologie de l'encéphale; Pathologie du système nerveux; Abcès cérébral; Chirurgie; Pathologie du système nerveux central; Suppuration
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2008.10.012

Abstract Background and purpose Cerebral abscesses are focal suppurations of infectious origin developed within the cerebral parenchyma. This is a rare pathology, with a relatively poor prognosis. Therapy continues to be debated and the results are inconsistent. The objectives of this study were to define the factors influencing prognosis. Methods In a search for predictive factors, we analyzed 80 observations of intracranial abscesses compiled between January 1990 and December 2004. Results We noted a strong male prevalence (7:1) with age ranging from three to 65 years. The duration of symptoms was short in 34 patients (42.5%). A motor deficit existed in 25 cases (31.25%), aphasia in five patients, and seizure in 11. A CT scan in 77 patients and MRI in three patients provided the diagnosis in all patients. The supratentorial location was found in 72.5% of the cases. Otitis ranked first among etiologies, followed by cranial injuries and sinusitis. The pathogenic agent found in the pus from the abscess was seldom found at the entry point. Staphylococcus aureus was found in 12.1% of the cases, followed by Proteus (11.8% of the cases). Seventy-eight patients underwent surgery, two were treated with antibiotics only, with favorable progression in 76.3%. We noted a 13.1% rate of complications and five deaths. Conclusions Comparing the data from this study with those of the literature, we observed that progression was better among young patients with a mean age of 20–35 years, a good level of consciousness, and supratentorial location.