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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El absceso cerebral es un proceso supurativo focal en el par&#233;nquima cerebral que todav&#237;a presenta una elevada mortalidad&#46; El resultado est&#225; altamente relacionado con un tratamiento precoz y adecuado&#46; Para valorar dicho tratamiento revisamos los abscesos cerebrales tratados en nuestro Servicio en los &#250;ltimos 14 a&#241;os</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos una revisi&#243;n de los 60 pacientes con diagn&#243;stico de absceso cerebral pi&#243;geno tratados en el Servicio de Neurocirug&#237;a del Hospital Infanta Cristina entre Enero de 1990 y Febrero de 2004&#44; prestando atenci&#243;n a la epidemiolog&#237;a&#44; cl&#237;nica&#44; etiolog&#237;a&#44; microbiolog&#237;a&#44; tratamiento y resultado final&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La relaci&#243;n hombre&#47;mujer es 5&#46;6&#47;1&#44; con una edad media de 47 a&#241;os&#59; el origen de la infecci&#243;n m&#225;s frecuente es el hemat&#243;geno&#44; seguido de las infecciones contiguas&#44; con un 22&#37; de abscesos de origen desconocido&#59; los g&#233;rmenes m&#225;s frecuentes son los cocos Gram positivos &#40;44&#37;&#41;&#44; con una importante presencia de g&#233;rmenes anaerobios &#40;40&#37;&#41;&#59; en un 39&#37; de los casos las infecciones son mixtas&#59; las modalidades de tratamiento fueron la punci&#243;n de los abscesos para aspiraci&#243;n-drenaje&#44; la cirug&#237;a abierta&#44; con o sin resecci&#243;n capsular&#44; y el tratamiento m&#233;dico exclusivo&#46; 52 pacientes &#40;86&#46;7&#37;&#41; curaron sin secuelas y 4 &#40;6&#44;7&#37;&#41; fallecieron&#46; Aunque los resultados de ambos tipos de tratamiento quir&#250;rgico son similares&#44; el drenaje del absceso requiri&#243; en un 20&#37; de los casos un segundo proceder quir&#250;rgico&#44; mientras que la craneotom&#237;a lo precis&#243; s&#243;lo en el 10&#37;&#59; la estancia media en nuestro hospital fue mucho menor en los abscesos tratados mediante drenaje que en los tratados mediante cirug&#237;a abierta &#40;13 vs 26 d&#237;as&#41;&#59; la mortalidad fue mayor en pacientes con bajo nivel de conciencia al ingreso y en mayores de 70 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Consideramos que la menor estancia media del drenaje del absceso&#44; unido a su alta eficacia y su baja morbilidad&#44; hacen aconsejable su uso como tratamiento de primera elecci&#243;n&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Brain abscess is a focal suppurative process in the brain parenchyma that still carries high mortality rates&#46; Outcome is closely related with a correct and early management&#46; In order to evaluate this management we have reviewed the brain abscesses treated in our Department during the last 14 years&#46;</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The authors present a retrospective series of 60 consecutive patients with pyogenic brain abscess treated between January of 1990 and February of 2004 paying attention to the epidemiology&#44; etiology&#44; clinical data&#44; microbiology&#44; treatment modalities and outcome</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The male to female rate was 5&#46;6 to 1&#46; The average age was 47 years&#46; Hematogenous spread was most frequent&#44; followed by contiguous spread&#46; In 22&#37; of the cases&#44; the origin was unknown&#46; Regarding the causative pathogens&#44; Gram positive cocci are the most frequent &#40;44&#37;&#41;&#44; with a 40&#37; incidence of anaerobics&#46; A mixed infection occurred in 39&#37; of the abscesses&#46; Three modalities of treatment were used&#58; non surgical&#44; catheter drainage-aspiration and surgical excision&#46; Outcome was excellent in 52 patients &#40;86&#46;7&#37;&#41; and 4 patients &#40;6&#46;7&#37;&#41; died&#46; Although outcome was similar in both surgical modalities&#44; drainage-aspiration required a second procedure in 20&#37; of the cases while this was necessary in only 10&#37; of the patients with abscess excision&#46; Length of admission was shorter in the drainageaspiration group than in the excision group &#40;13 and 26 days respectively&#41;&#46; Mortality was higher in patients with low level of consciousness and age over 70 years&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The shorter admission time associated with drainage-aspiration of brain abscesses together with its high efficacy and low morbidity suggests that drainageaspiration should be used as the first mode of treatment&#46;</p>"
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Abscesos piógenos encefálicos. Nuestra experiencia en 60 casos consecutivos
Pyogenic brain abscesses: experience with 60 consecutive cases
M. Ortega-Martínez
, J.M. Cabezudo, I. Fernández-Portales, L. Gómez-Perals, J.A. Rodríguez-Sánchez, L. García-Yagüe, L.F. Porras, L.M. Lorenzana, F. Ugarriza, M. Pineda-Palomo, L.M. Bernal-García
Servicio de Neurocirugía. Hospital Regional Universitario Infanta Cristina. Badajoz

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