To evaluate the neurological outcomes of children diagnosed with brain abscesses in the early post-treatment period.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 (GOS score 5). Unfavorable outcome was defined as having any kind of neurologic 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) were enrolled in this study. The most common presenting symptom was fever being encountered in 71% of the patients (n=22), followed in the frequency 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). Surgical procedures was 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 below 12 and presence of FND on admission were found to be independent risk factors for unfavourable neurological outcome.