[Treatment of brain abscess. Comparison between aspiration and extra-capsular total excision].

受 稿1985年9月20日 受 理1986年6月23日 Abstract Thirty-eight cases of brain abscess observed from 1959 to 1983 were analyzed. Thirty-seven cases were operated on and 22 cases out of these were treated with aspiration, 14 cases with extra-capsular total excision, and one case with ventricular drainage. The operative mortality and morbidity were compared between the aspiration group and the excision group. Total surgical mortality rate was 14%. The surgical mortality rate of the aspiration group was 17% and that of the excision group was 7%. Severe consciousness disturbance was observed preoperatively in approximately 30% of the aspiration group. Surgical morbidity of the aspiration group was more favorable than that of the excision group. Postoperative convulsion was observed in 21% of the aspiration group and 15% of the excision group. Recurrence of abscess was observed in only one patient, who had malignant lymphoma. Brain abscess is considered to be cured by aspiration, appropriate chemotherapy and control of intracranial pressure. Extra-capsular total excision is unnecessary except in cases such as those resisting repeated aspiration.