Brain abscess at the University Hospital of the West Indies

Surgical infections of the central nervous system are still attended by hig h rates of morbidity and mortality, although substantial progress has been made since the advent of computed tomography (CT) scanning technology. In t his retrospective review of 25 surgically treated patients with either brai n abscess or subdural empyema at the University Hospital of the West Indias , the majority of patients were male and between the ages of 10 and 30 year s with a mean age of 16.9 years. Almost half the patients had a hemiparesis on presentation while 60% had fever. Subdural empyema was more common than a localized intracerebral abscess which was most frequently located in the frontal lobe. The most common predisposing factors were sinusitis and cong enital heart disease. Streptococci spp and Staphylococci spp were the most frequently isolated organisms. All patients underwent CT scanning and surgi cal intervention. The mortality rare was 20% and 21% of the survivors had l ate seizures. There must be a high index of clinical suspicion and early, r eferral to specialist centres where neuroradiological investigation and pro mpt neurosurgical intervention can be carried out to minimize morbidity and mortality.