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This work analyzed 47 cases of oto- and rhinosinusogenic suppurative meningoencephalitis, abscesses and empyemas of the brain in children at the age from 3 months to 17 years old. The article presents the treatment strategy, results and the volume of diagnostic measures. On the basis of this research, the authors came to conclusion, that care of the children with otogenic and rhinosinusogenic suppurative diseases of the brain required an interdisciplinary approach and effective cooperation of a neurosurgeon, otolaryngologist, pediatrician, resuscitation specialist, infectionist and a clinical pharmacologist.
View Article and Find Full Text PDFTaming an old enemy: a profile of intracranial suppuration.
World Neurosurg
August 2012
Department of Neurosurgery, Wentworth Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Intracranial suppurative disorders (ICSDs; brain abscess, empyema, and purulent ventriculitis), have been a scourge through the ages and attempts at curative surgery, as for cranial trauma, are considered to be one of the first true neurosurgical interventions performed. ICSDs, seen initially as a consequence of poor socioeconomic conditions and neglected otorhinogenic infections, predominantly manifest today as postsurgical complications, and/or in immunocompromised patients where they continue to result in significant neurologic morbidity and death. The reduction in the incidence of "old world" classic ICSDs can be attributed to the modernization of society, driven inter alia by a shift from an agricultural to an industrial economic society.
View Article and Find Full Text PDFBrain abscess: management and outcome analysis of a computed tomography era experience with 973 patients.
World Neurosurg
August 2011
Department of Neurosurgery, Wentworth Hospital and University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
Objective: Brain abscess (BA) is a neurosurgical emergency and despite significant medical advances, it remains a surgical challenge. A single institution's two decade computed tomography era management experience with BA is reported.
Methods: A retrospective analysis of patients with BA, admitted to the Department of Neurosurgery, Wentworth Hospital, Durban, KwaZulu-Natal, South Africa, was performed.
The paper analyses treatment given to 125 patients with purulent intracranial processes combining with inflammatory diseases of the paranasal sinuses, ear and other diseases. Otorhinogenic genesis was diagnosed in 45.6% cases.
View Article and Find Full Text PDFSurgical intervention and heparin-anticoagulation improve prognosis of rhinogenic/otogenic and posttraumatic meningitis.
Acta Neurol Scand
April 1994
Department of Neurology, University of Würzburg, Germany.
It is still controversial, whether early surgical removal of infectious material and heparin-anticoagulation to reduce vascular complications will improve outcome in acute meningitis. In the present pilot-study 40 patients with acute or delayed post-traumatic or oto-/rhinogenic purulent bacterial meningitis were analysed for neurological outcome by using the Glasgow outcome score (GOS) and the Tuthill functional score; patients were treated either by early surgical revision of the septic focus (Group 1, within 6 days, n = 15), late surgery (Group 2, later than 6 days, n = 19), or no surgery at all (Group 3, n = 6). All patients, independent of surgical approach, received therapeutic heparin-anticoagulation.
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