Management of single brain abscesses with no entry found (about a serie of 7 cases)

Abstract

Aims: The brain abscesses can become serious if they are untreated or inadequately treated. The therapeutic management included the correct treatment of the original infection focus. This one is not always found. We report our experience on the management of brain abscess with no entry  at the end of which we will propose a decisional algorithm of treatment.

Patients and method

It is a retrospective and descriptive stdy from November 2014 to December 2016. It concerned patients of all ages treated for a brain abscess with no entry in neurosurgery department of Gabriel Touré University Hospital. The clinical, radiological and therapeutic parameters were studied.

Results

During our study period, the brain abscesses with no entry represented 33.3% of all brain abscesses and 63.6% of operated cerebral abscesses. The average age of the patients was 45 years old with a sex ratio of 0.7. All of patients in our cohort were immunocompetent. The fever and intracranial hypertension were the main signs. The lesion was principally frontal and temporal. All of our patients were treated by punture and drainage surgery combined with triantibiotherapy. The evolution was unfavorable in 28.6% of cases (recollection of abscesses). The evolution was satisfactory in 71.4% of the cases. Mortality was absent.

Conclusion

The clinical and radiological good evolution after the treatment of a brain abscess is no a warranty of the recovery as much as the initial infectiuous focus is no found and decently treated