Brain abcess of undetermined etiology : report of four cases with recovery / Joseph C. Yaskin [and others].

Date:
[1938?]
Catalogue details

Licence: In copyright

Credit: Brain abcess of undetermined etiology : report of four cases with recovery / Joseph C. Yaskin [and others]. Source: Wellcome Collection.

    1/16 (page 492)
    ANNALS OF SURGERY, evil 1938 APR. PAQl ZfQ ,'' BRAIN ABSCESS t)F ETERMINED ETIOLOGY* REPORT OFJ|t)UR CASES WITH RECOVERY Joseph C. Yasi^; Francis C. Grant, M.D., and Robert A. Groff, M.D. ^ r^LADELPHTA, Pa. FROM THE NEUROLOGIC.A^fND NEUROSURGICAL DE»RTMENTS OF THE GRADUATE SCHOOL OP MEDICINE, UNIVERSITY OF PENNSYL\%NIA. PHILADELPHIA, PA. It is^^3,^arent from personal experience and from a review of the litera¬ ture that in recent years the treatment of brain abscess has been more suc¬ cessful, and that complete, lasting recoveries have followed a correct diag¬ nosis and proper treatment. However, the diagnosis of brain abscess may often be most difficult. In fact, a preoperative diagnosis of brain abscess de¬ pends, in the majority of instances, not only upon evidences of the existence of a space-taking lesion in the brain, but also upon the finding of a possible cause for the presence of an abscess. In other words, we do not consider a brain lesion as being an abscess unless we have some definite infectious process which may account for such a lesion. The etiologic factors of brain abscess have been divided into three groups. Their relative frequency may best he appreciated by reference to the statistics compiled by Evans,^ and Parker- (Table I). Table I analysis of the causes of brain abscess in 2i6 cases {Evans'^ and Parker'^) (I) Direct Extension (1) Otitis media and mastoiditis. 109 (2) Suppuration in nose and accessory sinuses. 12 (3) Following trauma of skull. 8 (4) Invasion of skull by malignancy. 2 Total. (II) Hematogenous Spread (Metastatic) (1) Intrathoracic suppuration. 22 (2) Extrathoracic suppuration. 26 131 (Evans) 14 6 Totals 48 (Evans) 20 (Parker) Osteomyelitis and cystopyelitis were the most common initial lesions in this group. General sepsis occurred in the majority of cases. (Ill) Source of Infection Doubtful or Unknown. 17 (Evans) It is important to emphasize the fact that while the brain abscess usually develops in the course of acute infection in both Groups I and II, it may also * Presented before the Philadelphia Neurological Society, May 28, 1937. Submitted for publication, September 29, 1937. 492