Intracranial Abscesses in Ahmadu Bello University Teaching Hospital Zaria, Nigeria

Intra-cranial abscesses are important causes of morbidity and mortality as they present as space occupying lesions in any of the epidural, subdural, intra-parenchymal or intraventricular spaces. It is hoped that this study will identify the clinico-demographic pattern and outcome of management of intracranial abscesses. A retrospective study of patients managed for intra-cranial abscesses in Ahmadu Bello University Teaching Hospital, Zaria between January 2007 – October 2015 was conducted. Medical records of the patients were retrieved from the central library, operating theatres and microbiology laboratory, and relevant information including demographics, neurological status on admission, clinical presentation, predisposing factors, anatomical location, number of lesions, surgical techniques, organisms cultured, and the neurological outcome were extracted. Data were analyzed using SPSS version 21. Thirty seven (37) patients’ clinical information were obtained and analyzed. 30 were males (81.1%) and 7 were females (18.9%). The ages ranged between 3 months and 60 years (mean of 21). Intra-cerebral abscess accounted for 67.6% of cases, sub-dural empyema (21.6%), epidural abscess (8.1%), and intra-ventricular abscess 2.1%. More than one lobe was involved in 11 cases (44%). Parietal lobe was the most involved lobe (68%), then frontal (28%) and occipital lobe (24%). Burr hole and free hand drainage was the commonest modality of treatment (63.9%). The mean volume of abscess drained was 65.8mls (8200mls). Culture yielded no growth in 57.9% (n=19). Isolated organisms include Escherichiacoli (21.1%), and Staphylococcusaureus (15.8%). 86.6% of operated patients had Glasgow outcome score of ≥ 4. From our findings, Intra-cerebral abscess is the commonest form of intra-cranial abscess in Zaria affecting males predominantly. Burr hole and drainage is effective, and outcome of surgical management is good.