Intracranial Infections and the Neurosurgeon: A Clinico-Microbiological Study and the Management Perspective
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Introduction: In Intracranial Suppurative Infection patients, the infectious process attacks the CNS, which is incapable of exerting a significant immune defense generally leading to subdural empyema due to breach of the duramater. The aim of this work is to study the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of Central nervous system (CNS) infections. Materials and Methods: The present data was collected from patients who had been diagnosed with Intracranial Suppurative Infection. All the cases were managed by a single surgeon to rule out variability in technical aspects. Patients were retrospectively evaluated by review of the data, including physical examination, laboratory (biochemistry and microbiology) testing, and radiological examination collected. Results: Otogenic infection has been found to be the most common source of Intracranial Suppurative Infection, followed by sinusitis infection. Otogenic infections are associated with temporal and cerebellar abscess while sinusitis is generally associated with frontal abscess. One patient had CSF, rhinorrhea, managed conservatively. Two patients had wound gaping in craniotomy group, for which secondary suturing was done. 21 specimens yielded microbial flora of which Staph aureus and Streptococcus sp. were of equal frequency (7 cases each) followed by Pseudomonas(4 cases) and Enterococcus avium (3 cases). All Subdural empyema cases (50 cases) underwent craniotomy, burr hole and aspiration in 11 cases, re exploration were done in 3 cases, external ventricular drain in 7 cases and ventriculo peritoneal shunt in 2 cases. Conclusion: Delayed diagnosis of Intracranial Suppurative Infection, rapid progression, coma, multiple lesions, intraventricular rupture, lower Glasgow coma score at admission, have been reported as poor prognostic factors. Brain abscess excision has better results in the form of shorter hospital stay, short duration of antibiotic coverage and patient outcome, compared to aspiration but in deep seated lesions, one can go for aspiration to prevent neurological deficit.
Authors and Affiliations
Tushar Soni, Jasdeep Singh
Keywords
Related Articles
- EP ID EP537119
- DOI 10.21276/ijmrp.2018.4.5.061
- Views 75
- Downloads 0
Comparative Evaluation of Prognosis of Patients with Hip Fracture among Different Age Groups: An Institution Based Study
Background: Hip fracture is one of the common fractures reported among both the young and elderly population in the recent time. Approximately 60 to 80 percent of the patients with hip fractures have been reported to be...
Fatty Giant from the Pelvis: An Unusual Case of Giant Broad Ligament Lipoleiomyoma
Primary lipoid tumors of the uterus are rare and usually benign. We report a case of a giant lipoleiomyoma of broad ligament which is even rarer. Lipoleiomyoma is a rare variant of uterine leiomyoma composed of an admixt...
Attitude of Undergraduate Medical Students towards Medico-Legal Autopsies at I.G.I.M.S., Patna, Bihar
Objectives: To study the attitude of undergraduate medical students towards medico-legal autopsies. Methods: In this cross - sectional study, 107 students of 6th semester of MBBS were selected for the study. The students...
Assessment of Prosthetic Complications Associated with Dental Implants: An Observational Study
Background: Clinical prosthodontics, during the past decade, has significantly improved and developed according to the advancements in the science and patient's demands and needs. Despite its high success rate, failure a...
Oxygen Saturation (SpO2) in Healthy Newborns in Relation to Mode of Delivery, Delivered at a Tertiary Care Institute of Solan
Introduction: Measurement of SpO2 is an integral part of newborn, as both hypoxia and hyperoxia are dangerous. Normal newborn takes about 10 minutes to reach a SpO2 of 85%- 95%. Lungs of babies born by Cesarean section c...