Management of brain abscess: an overview

Abstract

Recent advances in neuroimaging have resulted in a marked decrease in morbidity and death due to brain abscesses. The advent of computed tomography–guided stereotaxy has reduced morbidity in patients with deep-seated abscesses. Empirical therapy is best avoided in the present era, particularly given the availability of stereotactic techniques for aspiration and confirmation of diagnosis. Despite these advances, management of abscesses in patients with cyanotic heart disease and in immunosuppressed patients remains a formidable challenge. Unusual as well as more recently recognized pathogens are being isolated from abscesses in immunosuppressed patients. The authors provide an overview of the management of brain abscesses, highlighting their experience in managing these lesions in patients with cyanotic heart disease, stereotactic management of brain abscesses, and management of abscesses in immunosuppressed patients.