Experience with brain abscesses

Abstract

✓ Eighty-six patients with brain abscesses were seen at the University of Minnesota Hospitals from 1946–1965, and 46 died, a 53% mortality. Multiple and brain stem abscesses accounted for several fatalities, while delayed and missed diagnosis accounted for one third of the deaths. Evidence of infection was often minimal in patients with brain abscess. Lumbar puncture as a diagnostic tool was inaccurate and occasionally fatal. Brain scan, electroencephalography, and angiography were the best diagnostic tests. Drainage and excision were each associated with approximately a 20% mortality. The most pertinent correlation regarding treatment, however, was that of increasing mortality with deteriorating preoperative neurological status. Postoperative deaths were due to failure in locating the abscess at surgery or untoward events such as cerebritis, edema, or excessive bleeding at the operative site.