Turkish Neurosurgery 2018 , Vol 28 , Num 1
Evaluation of Short-Term Neurological Outcomes in Children with Brain Abscesses
1Istanbul University, Istanbul Medical Faculty, Department of Pediatric Infectious Diseases, Istanbul, Turkey
2Istanbul University, Istanbul Medical Faculty, Department of Pediatric Neurology, Istanbul, Turkey
3Istanbul University, Istanbul Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.18672-16.1 AIM: To evaluate the neurological outcomes of children diagnosed with brain abscesses in the early post-treatment period.

< b>MATERIAL and METHODS: This study was a retrospective analysis of pediatric brain abscess patients between January 2000 and December 2015, during a 16-years period. Patients were divided into two groups according to their outcome at the end of the treatment. The patients with "good outcome" were the ones without any neurological sequelae [Glasgow Outcome Scale (GOS) score 5]. "Unfavorable outcome" was defined as having any kind of neurological deficit (GOS score 1-4).

RESULTS: A total number of 31 patients (22 male, 71%) with the median age at diagnosis of 84 months (range, 1-202 months) were enrolled in this study. The most common presenting symptom was fever being encountered in 71% of the patients (n=22), followed by focal neurological deficit (FND)(n=17, 54.8%), vomiting (n=14, 45.2%), headache (n=13, 41.9%), seizure (n=13, 41.9%), change in mental status (n=12, 38.7%) and visual disturbance (n=2, 6.5%). Twenty-four patients (77.4%) had predisposing factors. The most common pathogens were gram-positive cocci (n=9, 29%). Seventeen patients (54.8%) had unfavorable outcome; 2 patients (6.4%) died. All patients were treated with parenteral antibiotherapy with median duration of 73 days (range, 28-540 days). Surgical procedures were performed in 83.9% (n=26) of patients [isolated aspiration (n=19, 61.3%), only resection (n=5, 16.1%), aspiration and resection (n=2, 6.5%)].

CONCLUSION: Glasgow coma scale score below 12 and the presence of FND on admission were found to be independent risk factors for unfavourable neurological outcome in children with brain abscesses. Keywords : Brain abscess, Child, Neurological outcome

Corresponding author : Murat SUTCU, sutcu13@yahoo.com