Kutlay M, Colak A, Yildiz S, Demircan N, Akin ON, et al.
Neurosurgery. Date of publication 2008 Feb 1;volume 62 Suppl 2():540-6.
1. Neurosurgery. 2008 Feb;62 Suppl 2:540-6. doi: 10.1227/01.neu.0000316257.21478.5b.
Stereotactic aspiration and antibiotic treatment combined with hyperbaric oxygen
therapy in the management of bacterial brain abscesses.
Kutlay M(1), Colak A, Yildiz S, Demircan N, Akin ON.
Author information:
(1)Department of Neurosurgery, GATA Military Medical Academy, Haydarpaşa Training
Hospital, Istanbul, Turkey. mkutlay@superonlie.com
Republished from
Neurosurgery. 2005 Dec;57(6):1140-6; discussion 1140-6.
OBJECTIVE: Despite advances in surgical techniques in the management of the brain
abscess, long-term antibiotics are as crucial to cure as the initial surgical
procedure itself. This study was designed to evaluate the effect of adjuvant
hyperbaric oxygen (HBO) therapy on the duration of antibiotic treatment.
METHODS: Between 1999 and 2004, 13 patients with bacterial brain abscesses
treated with stereotactic aspiration combined with HBO and systemic antibiotic
therapy. Patients younger than 18 years of age were excluded from this study.
Postoperatively, all patients were given a 4-week course of intravenous
antibiotics. Additionally, patients received hyperbaric oxygen (HBO, 100% O2 at
2.5 ATA for 60 min) twice daily for five consecutive days, and an additional
treatment (100% O2 at 2.5 ATA for 60 min daily) was given for 25 days.
RESULTS: There were eight male and five female patients. Their ages ranged
between 18 and 71 years, with a mean of 43.9 years. The average duration of
follow-up was 9.5 months (range, 8-13 mo). This treatment modality allowed
infection control and healing for all 13 patients with 0% recurrence rate. HBO
treatment was tolerated well, and there were no adverse effects of
pressurization. At the end of the follow-up period, 12 patients had a good
outcome: nine are without sequelae, and three have a mild hemiparesis but are
capable of self-care. One patient has a moderate hemiparesis.
CONCLUSION: Although the number of patients is small, this series represents the
largest reported group of brain abscess patients treated with stereotactic
aspiration combined with antibiotic and HBO therapy. Our preliminary results
indicate that the length of time on antibiotics can be shortened with the use of
HBO as an adjunctive treatment.
DOI: 10.1227/01.neu.0000316257.21478.5b
PMID: 18596450
