Intracranial abscesses in infancy and childhood: report of 40 cases

Oliveira, Talvany D.; Reimão, Rubens; Diament, Aron J.

doi:10.1590/S0004-282X1984000300001

Abstracts

Forty cases of brain abscesses in patients under 15 years of age observed between 1960 and 1982 are reported in this study. There has been a progressive decrease in the number of admissions due to that disease. The typical clinical picture was subacute and characterized by intracranial hypertension, fever, alterations in the level of consciousness, seizures and signs of localization in a decreasing order of frequency. Otites and sinusites predominated as primary foci and the most common localizations were frontal and parietal. Electroencephalogram and examination of the cerebrospinal fluid were useful. Currently, computerized tomography is indicated as the test of choice. Thirty-four patients underwent surgeries and the mortality rate was 35.2%.

São relatados 40 casos de abscessos intracranianos em pacientes abaixo de 15 anos de idade, observados de 1960 a 1982. Houve decréscimo progressivo no número de internações por esta patologia. O quadro clínico típico foi subagudo e caracterizou-se por hipertensão intracraniana, febre, alterações do nível de consciência, convulsões e sinais de localização, em ordem decrescente de freqüência. Otites e sinusites predominavam como focos primários e as localizações mais comuns foram frontais e parietais. Eletrencefalograma e líquido cefalorraquidiano revelaram-se úteis. Atualmente, a tomografia computadorizada é indicada como exame de primeira escolha. Trinta e quatro pacientes foram submetidos à cirurgia, tendo sido a mortalidade de 35,2%.

Intracranial abscesses in infancy and childhood. Report of 40 cases

Abscessos intracranianos na infância. Estudo de 40 casos

Talvany D. Oliveira^I; Rubens Reimão^II; Aron J. Diament^III

^IResident Physician. Department of Neuropsychiatry "Hospital das Clínicas" - University of São Paulo School of Medicine

^IIAssociate Physician. Department of Neuropsychiatry "Hospital das Clínicas" - University of São Paulo School of Medicine

^IIIHead of Pediatric Neurology Section. Department of Neuropsychiatry "Hospital das Clínicas" - University of São Paulo School of Medicine

SUMMARY

Forty cases of brain abscesses in patients under 15 years of age observed between 1960 and 1982 are reported in this study. There has been a progressive decrease in the number of admissions due to that disease. The typical clinical picture was subacute and characterized by intracranial hypertension, fever, alterations in the level of consciousness, seizures and signs of localization in a decreasing order of frequency. Otites and sinusites predominated as primary foci and the most common localizations were frontal and parietal. Electroencephalogram and examination of the cerebrospinal fluid were useful. Currently, computerized tomography is indicated as the test of choice. Thirty-four patients underwent surgeries and the mortality rate was 35.2%.

RESUMO

São relatados 40 casos de abscessos intracranianos em pacientes abaixo de 15 anos de idade, observados de 1960 a 1982. Houve decréscimo progressivo no número de internações por esta patologia. O quadro clínico típico foi subagudo e caracterizou-se por hipertensão intracraniana, febre, alterações do nível de consciência, convulsões e sinais de localização, em ordem decrescente de freqüência. Otites e sinusites predominavam como focos primários e as localizações mais comuns foram frontais e parietais. Eletrencefalograma e líquido cefalorraquidiano revelaram-se úteis. Atualmente, a tomografia computadorizada é indicada como exame de primeira escolha. Trinta e quatro pacientes foram submetidos à cirurgia, tendo sido a mortalidade de 35,2%.

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Study performed at the Department of Neuropsychiatry "Hospital das Clínicas" - University of São Paulo School of Medicine.

Clínica Neurológica, Departamento de Neuropsiquiatria, Faculdade de Medicina da Universidade de São Paulo - Caixa Postai 3461 - 01000, São Paulo, SP - Brasil.

References

1. ALPHEN, H. A. & DREISSEN, J. J. R. - Brain abscess and subdural empyema. J. Neurol. Neurosurg. Psychiat. 39:481, 1976.
2. BHATIA, M. S.; TANDON, P. N. & BANERJI, A. K. - Brain abscess. An analysis of 55 cases. Int. Surg. 58:565, 1973.
3. BHATIA, R.; TANDON, P. N.; BANERJI, A. K. & PRAKASH, B. - Brain abscess and congenital heart disease. Acta neurochir. 33:233, 1976.
4. BREWER, N. S.; MacCARTY, C. S. & WELLMAN, W. E. - Brain abscess: a review of recent experience. Ann, int. Med. 82:571, 1975.
5. CAREY, M. S.; CHOTJ, S. N. & FRENCH, L. A. - Long-term neurological residual in patients surviving brain abscess with surgery. J. Neurosurg. 34:652, 1971.
6. FREDERICK, J. & BRATJDE, A. I. - Anaerobic infection of the paranasal sinuses. New Engl. J. Med. 290:135, 1974.
7. FRENCH, L. A. & CHOTJ, S. N. - Treatment of brain abscesses. In: R. A. Thompson & J. R. Green (eds.) - Advances in Neurology, vol. 6. Raven Press, New York, 1974, pg. 260.
8. GARFIELD, J. - Management of supratentorial intracranial abscess: a review of 200 cases. Brit. med. J. 2:7, 1969.
9. HOFFMAN, H. J.; HENDRICK, E. B. & HISCOX, J. L. - Cerebral abscesses in early infancy. J. Neurosurg. 33:172, 1970.
10. LE BEAU, J.; CREISSARD, P.; HARISPE, L. & REDONDO, A. - Surgical treatment of brain abscess and subdural empyema. J. Neurosurg. 38:198, 1973.
11. LEFÈVRE, A. B. - Estudo clinico dos tumores intracranianos em crianças. Rev. Hosp. Clin. Fac. Med. S. Paulo. 21:1, 1966.
12. LEGG, N. J.; GUPTA, P. C. & SCOTT, D. F. - Epilepsy following cerebral abscess. Brain 96:259, 1973.
13. LERNER, P. I. - Selection of antimicrobial agents in bacterial infections of the nervous system. In: R. A. Thompson & R. Green (eds.) - Advances in Neurology, vol. 6. Raven Press, New York, 1974, pg. 176.
14. McGREAL, D. A. - Brain abscess in children. Canad. med. Ass. J. 86:261, 1962.
15. MORGAN, H. & WOOD, M. W. - Cerebellar abscesses: a review of seventeen cases. Surg. Neurol. 3:93, 1975.
16. MORGAN, H.; WOOD, M. W. & MURPHEY, F. - Experience with 88 consecutive cases of brain abscess. J. Neurosurg. 38:698, 1973.
17. MUNSLOW, R. A.; STOVALL, V. S.; PRICE, R. D. & KOHLER, C. - Brain abscess in children. J- Pediat. 51:74, 1957.
18. NESTADT, A.; LOWRY, R. B. & TURNER, E. - Diagnosis of brain abscess in infants and children. Lancet 2:449, 1960.
19. NEWLANDS, W. J. - Otogenic brain abscess. A study of eighty cases. J. Laryng. 79:120, 1965.
20. SHAW, M. D. M. & RUSSESS, J. A. - Cerebellar abscess. A review of 47 cases. J. Neurol. Neurosurg. Psychiat. 38:429, 1975.
21. WRIGHT, J. L. W. & GRIMALDI, P. M. G. B. - Otogenic intracranial complications. J. Laryng. 87:1085, 1973.

Publication Dates

Publication in this collection
13 Aug 2012
Date of issue
Sept 1984

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALPHEN, H. A. & DREISSEN, J. J. R. - Brain abscess and subdural empyema. J. Neurol. Neurosurg. Psychiat. 39:481, 1976.

[2] 2. BHATIA, M. S.; TANDON, P. N. & BANERJI, A. K. - Brain abscess. An analysis of 55 cases. Int. Surg. 58:565, 1973.

[3] 3. BHATIA, R.; TANDON, P. N.; BANERJI, A. K. & PRAKASH, B. - Brain abscess and congenital heart disease. Acta neurochir. 33:233, 1976.

[4] 4. BREWER, N. S.; MacCARTY, C. S. & WELLMAN, W. E. - Brain abscess: a review of recent experience. Ann, int. Med. 82:571, 1975.

[5] 5. CAREY, M. S.; CHOTJ, S. N. & FRENCH, L. A. - Long-term neurological residual in patients surviving brain abscess with surgery. J. Neurosurg. 34:652, 1971.

[6] 6. FREDERICK, J. & BRATJDE, A. I. - Anaerobic infection of the paranasal sinuses. New Engl. J. Med. 290:135, 1974.

[7] 7. FRENCH, L. A. & CHOTJ, S. N. - Treatment of brain abscesses. In: R. A. Thompson & J. R. Green (eds.) - Advances in Neurology, vol. 6. Raven Press, New York, 1974, pg. 260.

[8] 8. GARFIELD, J. - Management of supratentorial intracranial abscess: a review of 200 cases. Brit. med. J. 2:7, 1969.

[9] 9. HOFFMAN, H. J.; HENDRICK, E. B. & HISCOX, J. L. - Cerebral abscesses in early infancy. J. Neurosurg. 33:172, 1970.

[10] 10. LE BEAU, J.; CREISSARD, P.; HARISPE, L. & REDONDO, A. - Surgical treatment of brain abscess and subdural empyema. J. Neurosurg. 38:198, 1973.

[11] 11. LEFÈVRE, A. B. - Estudo clinico dos tumores intracranianos em crianças. Rev. Hosp. Clin. Fac. Med. S. Paulo. 21:1, 1966.

[12] 12. LEGG, N. J.; GUPTA, P. C. & SCOTT, D. F. - Epilepsy following cerebral abscess. Brain 96:259, 1973.

[13] 13. LERNER, P. I. - Selection of antimicrobial agents in bacterial infections of the nervous system. In: R. A. Thompson & R. Green (eds.) - Advances in Neurology, vol. 6. Raven Press, New York, 1974, pg. 176.

[14] 14. McGREAL, D. A. - Brain abscess in children. Canad. med. Ass. J. 86:261, 1962.

[15] 15. MORGAN, H. & WOOD, M. W. - Cerebellar abscesses: a review of seventeen cases. Surg. Neurol. 3:93, 1975.

[16] 16. MORGAN, H.; WOOD, M. W. & MURPHEY, F. - Experience with 88 consecutive cases of brain abscess. J. Neurosurg. 38:698, 1973.

[17] 17. MUNSLOW, R. A.; STOVALL, V. S.; PRICE, R. D. & KOHLER, C. - Brain abscess in children. J- Pediat. 51:74, 1957.

[18] 18. NESTADT, A.; LOWRY, R. B. & TURNER, E. - Diagnosis of brain abscess in infants and children. Lancet 2:449, 1960.

[19] 19. NEWLANDS, W. J. - Otogenic brain abscess. A study of eighty cases. J. Laryng. 79:120, 1965.

[20] 20. SHAW, M. D. M. & RUSSESS, J. A. - Cerebellar abscess. A review of 47 cases. J. Neurol. Neurosurg. Psychiat. 38:429, 1975.

[21] 21. WRIGHT, J. L. W. & GRIMALDI, P. M. G. B. - Otogenic intracranial complications. J. Laryng. 87:1085, 1973.

Intracranial abscesses in infancy and childhood: report of 40 cases

Abscessos intracranianos na infância: estudo de 40 casos

Abstracts

References

Publication Dates