Treatment Outcome of Superficial Cerebral Abscess: An Analysis of Two Surgical Methods|
Tan, Wei Ming; Adnan, Johari Siregar & Haspani, Mohamad Saffari Mohamad
Background: The purpose of the study is to compare the two surgical methods (burr hole
and craniotomy) used as treatment for superficial cerebral abscess and its outcome in terms of
radiological clearance on brain CT, improvement of neurological status, the need for repeated surgery,
and survival and morbidity at three months after surgery. This report is a retrospective case
review of the patients who were treated surgically for superficial cerebral abscess in Hospital Kuala
Lumpur (HKL) and Hospital Sultanah Aminah (HSA) over a period of four years (2004 to 2007).
Methods: Fifty-one cases were included in this study: 64.7% of patients were male and 35.5%
were female. Most of the patients were Malay (70.6%); 28 patients (54.9%) had undergone craniotomy
and excision of abscess, and the rest had undergone burr hole aspiration as their first surgical
Results: This study reveals that patients who had undergone craniotomy and excision of abscess
showed a significantly earlier improvement in neurological function, better radiological clearance
and lower rate of re-surgery as compared to the burr hole aspiration group (P-value < 0.05).
However, with respect to neurological improvement at 3 months, morbidity and mortality, there is
no significant difference between the two surgical methods.
Conclusion: The significance of these findings can only be confirmed by a prospective randomised
series. Further study will be required to assess the cost effectiveness, intensive care needs,
and possibility of shorter antibiotic usage as compared to burr hole aspiration.
burr hole aspiration cerebral abscess, craniotomy excision, neurosciences