Postoperative intracranial abscess--clinical aspects in the differential diagnosis to early recurrence of malignant glioma

Clinical Neurology and Neurosurgery
J P VogelsangE Markakis

Abstract

Out of 2941 patients who received a clean, major craniotomy, 39 patients (1.3%) developed the complication of an intracranial deep infection, i.e. abscess or empyema. A total of 14 patients with a postoperative abscess were initially operated upon intracerebral malignant glioma (WHO III or IV) and could be compared to a matched group of patients with recurrent malignancy concerning clinical and radiological aspects. A statistically significant elevation of median values was seen for erythrocyte sedimentation rate (ESR), fibrinogen and body temperature in the study group. C-reactive protein (CRP) was not investigated in the control group and could not be compared, but it was elevated in all abscess patients when measured. CT-scan did not allow a safe differentiation between infection and recurrent glioma. Local signs like suppuration of the wound could be observed in 71% of patients with intracranial infection. Postoperative abscesses had been diagnosed in all cases within 3 months, whereas none of the early recurrences of intracerebral malignoma became symptomatic before 12 weeks after initial operation. Therefore, the course of time seems to be another important factor in this differential diagnosis.

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Citations

May 22, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Christopher A SarkissJudy Huang
Sep 2, 2003·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Y KoS J Oh
Jun 4, 2008·Neurosurgical Focus·Shervin R DashtiNicholas C Bambakidis
Jun 4, 2008·Neurosurgical Focus·Ersin Erdoğan, Tufan Cansever
Jun 23, 2005·Enfermedades infecciosas y microbiología clínica·Antonio LaluezaRafael San Juan
Mar 2, 2010·Expert Review of Neurotherapeutics·Anna P AndreouPeter J Goadsby
May 1, 2019·The Cochrane Database of Systematic Reviews·Daniel Molano FrancoJavier Zamora
Mar 5, 2008·Journal of Neuro-oncology·Ondrej KalitaMichael Houdek

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