Ten year review of brain abscess in Children's Hospital Bangkok, Thailand.

Brain abscesses are the most common form of intracranial suppurative process in children. In ten years, 54 cases of brain abscess in the Children's Hospital, Bangkok were diagnosed mostly on the basis of clinical features, roentgenogram, CT scanning and basic laboratory findings. The age distribution of brain abscess was from 3 months to 14 years. Evidence of signs of increased ICP was frequently present. Almost half of the patients had associated congenital heart disease particularly Tetralogy of Fallot. CT scanning was very useful in the advantage of rapid diagnosis, early management and short and long-term follow-up, by decreasing the mortality of the patients. Definite diagnosis must be established by obtaining pus or infected ncrotic brain for culture. Brain abscess bacteria can be recovered from properly performed culture. In our series, anaerobic peptostreptococci was the organism most frequently encountered. In the present series, the mortality rates for antibiotic alone and for antibiotic plus aspiration or followed by excision showed no significant difference. Most of deaths were due to brain herniation. It is concluded that with earlier diagnosis, with CT scanning technology, with appropriate antibiotics and with the use of proper surgical methods, the mortality rate from brain abscess should be zero and neurological deficit should be reduced as well.