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Vol. 13. Issue 1.
Pages 6-14 (January 2002)
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Vol. 13. Issue 1.
Pages 6-14 (January 2002)
Colecciones purulentas intracraneales. Revisión de 34 casos tratados quirúrgicamente a lo largo de doce años (1989–2000)
Intracranial Purulent Collections. A revisión of 34 cases surgically treated during the last twelve years (1989–2000)
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J.M. Borras
, M. Garcia-Bach, J.I. Maestro-de León, A. Aparicio, N. Juan, J. Martínez-Lacasa, S. Quintana, F. Vila
Servicio de Neurocirugía. Hospital Mutua de Terrassa. Terrassa (Barcelona)
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Resumen

Se han revisado un total de 34 supuraciones cerebrales, 31 abscesos y 3 empiemas subdurales, tratados en el Servicio de Neurocirugía de la “Mutua de Terrassa” en el intervalo transcurrido entre 1989 y 2000. El tratamiento elegido fue quirúrgico mediante punción aspiración en 28 casos y en sólo dos hubo de practicarse una craneotomía con resección en bloque del absceso. Los tres empiemas subdurales fueron evacuados mediante trépanos y aspiración.

En lo que respecta a resultados, a los seis meses de seguimiento hubo siete exitus (20,6%), diecisiete obtuvieron una recuperación completa (50%) y diez presentaron secuelas mínimas (29,4%). El Glasgow Coma Score inicial y la edad fueron las únicas variables que obtuvieron significancia estadística en el pronóstico final.

Se analizan los costes del tratamiento de estas lesiones y se propone para el futuro la posibilidad de introducir el tratamiento antibiótico ambulatorio, una vez que la enfermedad se haya controlado clínica y radiológicamente, que permite acortar la habitual prolongada hospitalización de los enfermos con enfermedades supurativas intracerebrales.

Palabras clave:
Absceso cerebral
Empiema
Cultivo bacteriológico
Análisis del coste
Tratamiento ambulatorio
Summary

We made a revision of 34 cases of intracerebral supurations (31 brain abscesses and 3 subdural empyemas) treated at our department of neurosurgery of “Mutua de Terrassa” during the period of 1989–2000.

Treatment used was tapping of the abscess and aspiration in 28 cases and craneotomy and resection in only two cases. Three subdural empyemas were treated with burrholes and aspiration.

Results were evaluated using the Glasgow Outcome Scale at 6 months after discharge, resulting in 7 deaths (20,6%), 17 fully recovered patients (50%) and 10 with minor deficits (29,4%). Glasgow Coma Score at admission and the age were the unique variables significantly correlated with the final outcome.

After analyzing the cost of treatment in our patients we suggest using antibiotic ambulatory treatment when the disease shows an adequate clinical and radiological response, thus permitting to shorten the usually long period of hospitalization of patients with intracerebral supurative diseases.

Key words:
Brain abscess
Empyema
Punction-aspiration
Bacteriological culture
Cost analysis
Ambulatory treatment

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