Les abces et empyemes cerebreaux / Abscess and empyema of the brain

ABSTRACT

Brain abscess and subdural empyema are serious infections which can be metastasis of chronic suppurative diseases (bronchectasia, lung orabdominal abscess) or of congenital cardiopathy, but they are more frequently seen in healthy adults suffering from chronic sinusitis or otitis. Brain CT scan with contrast media injection is the best tool for diagnosis and follow-up. It has transformed the prognosis of brain abscesses. Anaerobic oropharyngeal microflora is the main source of bacteria responsible for suppurative brain diseases. Surgical treatment consist of aspiration or, rarely now, of excision of the lesion. Medical treatment alone can be successfull in selected cases, provided patients are closely monitored and antibiotics with good penetration into the brain parenchyma are used