EXPERIENCE WITH BRAIN-ABSCESS IN THE CENTRAL PROVINCE OF SAUDI-ARABIA

The characteristics of brain abscess in the Central Province of Saudi Arabia are outlined in this report which is a review of 22 consecutive cases that were treated at King Khalid University Hospital between 19 85-1991. The incidence of brain abscess in Saudi Arabia is calculated to be 3.6 cases/500,000 population/year which is twice as high as the incidence reported from the West, There were 17 males and 5 females wi th an age range of 8 months-80 years (mean 29.9 years). The parietal l obe was involved in 27%, while the abscess was in the posterior fossa in 14% and multiple in another 14% of cases. The primary source of sep sis was unknown in 50%, post-traumatic in 18% and from a dental and ma stoid origin in 14% of cases only. Duration of symptoms ranged between 4-30 days (mean 12 days). Fever was present in 55% of cases and epile psy in 23%. Sixteen (73%) cases had burr hole aspiration, while 3 (14% ) had craniotomy and excision, and 3 (14%) cases were managed with ant imicrobial treatment only, Staphylococci were the pathogens in 27%, wh ile streptococci were cultured in 23% cases and the culture was negati ve in 23%. Three (14%) cases all of which died had fungal abscesses ca used by Fonsecaea pedrosoi. The mortality was 18%, good recovery in 68 % and fair recovery in 14%. Follow up was from 3 months to 5.5 years ( mean 1.8 years).