Surgical Treatment and Prognosis of Patients With Brain Abscesses: A Retrospective Study

Background This study aimed to analyze the surgical treatment and prognosis of patients with brain abscesses. Methods Case records of 45 patients who had been discharged from the Fourth Hospital of Hebei Medical University between August 2006 and March 2024 after undergoing surgical treatment for a diagnosis of brain abscess were reviewed. The epidemiology, causes, treatment, and prognostic factors associated with brain abscesses surgeries were documented. Results Of the 45 patients with surgically treated brain abscesses, the mean age was 52 y, and 73.3% were male. Cryptogenic infections (62.2%) were the most common cause of infection. Only 6.7% of the patients showed the classic triad of symptoms. Cultures of pus or cerebrospinal fluid showed positive results in 40% of the patients, and the Streptococcus genus was the predominant pathogen in the positive cultures (44.4%). The preoperative and postoperative Karnofsky Performance Scale (KPS) scores were 56.67 ± 21.85 and 83.33 ± 20.56, respectively ( p < 0.05). The type of surgery did not affect the prognosis (odds ratio [OR] [95% confidence interval [CI]]: 1.05 [0.16–6.76]; p > 0.05). Patients with multiple brain abscesses were more likely to have a poor postoperative prognosis ( p < 0.05). Conclusions Our results indicate that surgically treated brain abscesses occur more frequently in male patients, and the presence of multiple brain abscesses increases the risk of poor prognosis. Cryptogenic brain abscesses are currently the most common type, and Streptococcus is the most frequently isolated pathogen. Surgical treatment improves the quality of life in patients with brain abscesses, whereas the choice of surgical approach—craniotomy excision or stereotactic aspiration—does not affect prognosis in surgically managed patients.