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Shifting paradigm in brain abscess management at tertiary care centre in Nepal

Neuroimmunology and Neuroinflammation 2018年第6期5卷 10-17页

作者： Prakash Kafle Mohan Raj Sharma Sushil Krishna Shilpakar Gopal Sedain Amit Pradhanang Ram Kumar Shrestha Binod Raj Bhandari Christine Groves Department of Neurosurgery Nobel Medical College Teaching HospitalBiratnagar56613Nepal Department of Neurosurgery Tribhuvan University Teaching HospitalKathmandu44613Nepal Department of Physical Medicine and Rehabilitation Indiana University School of MedicineIndianapolisIN46202USA

Aim: Brain abscess is a challenging clinical entity with substantial high case fatality rates despite significant advances in imaging techniques,laboratory modalities,surgical interventions,and antimicrobial *** and cardiogenic sources are among the most *** clinical presentation is seen in very few cases *** hole with aspiration works well with good clinical *** of primary source in cases of ear infection in the single setting results in good outcomes,reduces for additional surgery,and decreases the duration of hospital ***: This is prospective observational study conducted at Institute of Medicine,Tribhuvan University Teaching Hospital,Kathmandu,Nepal over the period of two and a half years(from September 2014 to March 2017).We analyzed the demographic profile,management strategies and outcome of these cases diagnosed with brain abscess using Microsoft Excel ***: A total of 51 cases were undertaken for surgical *** were 35 males and 16 females with the male to female ratio of 2.18:*** mean age of the study population was 16.76 years with age range from 4 months to 60 *** source was the most *** lobe was the most common abscess *** was the most common clinical presentation and was seen in 86.27%of the study *** cases were initially managed with burrhole and aspiration of the *** 3.92%(n = 2)of cases subsequently required surgical excision of the abscess *** 11.76%(n = 6)of the cases required multiple *** 19.61%(n = 10)showed positive *** aeruginosa and *** were the most common organisms *** rate among the study group was 3.92%.Conclusion: With the advent of modern technology in neuroimaging,mortality due to brain abscess has significantly *** involvement of the otorhinolaryngology team and efforts in addressing the primary source have further helped in improving outcomes i

关键词： Abscess otogenic brain abscess tubercular abscess

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