Preoperative Volumetric Assessment Matched with High-Field Intraoperative Magnetic Resonance Imaging-Guided Stereotactic Evacuation of Brain Abscesses
| Autor: | Alessandro Frati, Alessandro Pesce, Giancarlo D'Andrea, Riccardo Caruso, Venceslao Wierzbicki, Antonino Raco |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Brain Abscess Intraoperative MRI Stereotaxic Techniques 03 medical and health sciences 0302 clinical medicine medicine Brain abscess cerebral infections intraoperative MRI short antibiotic therapy stereotactic evacuation neurology (clinical) surgery Humans 030212 general & internal medicine Abscess Aged medicine.diagnostic_test business.industry Glasgow Outcome Scale Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Outcome and Process Assessment Health Care Cohort Stereotaxic technique Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | World Neurosurgery. 91:238-244 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2016.03.064 |
| Popis: | Objective and Background Stereotactic evacuation is currently accepted as a minimally invasive surgical procedure for the management of brain abscesses. Intraoperative magnetic resonance imaging (Io-MRI) is well established in neuro-oncology but its role has not been completely outlined for brain abscess surgery. The objective of this work is to analyze radiologic, clinical, and laboratory results in a cohort of patients with brain abscesses treated with an original protocol in which the minimally invasiveness of a stereotactic technique is matched with preoperative volumetric evaluation and Io-MRI. Methods For each of the 12 patients included in this cohort, the following data were recorded: age, sex, location, presentation, grade of evacuation, duration of follow-up, mean preoperative and postoperative Glasgow Outcome Scale score, functional outcome, number of abscess loculations, number of Io-MRI, duration of antibiotic therapy, preoperative and postoperative laboratory findings, pathogen strains and possible recurrences. Results The operative time was in 10/12 patients under 90 minutes. A total of 8/12 patients needed no more than 30 days of antibiotics; 9/12 patients had minor or no sequelae and returned to normal activities; only 1 recurrence of brain abscess was recorded in the sample. Only 1 death was recorded in the sample. Conclusions Although this work is intended to present preliminary results of an original protocol for the management of brain abscess, the role of a precise preoperative volumetric evaluation matched with Io-MRI in the treatment of this disease seems of great benefit, as in surgical neuro-oncology. |
| Databáze: | OpenAIRE |
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