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J Neurol Surg A Cent Eur Neurosurg 2021; 82(05): 446-452
DOI: 10.1055/s-0040-1720989
Original Article

Safety and Accuracy of Ultrasound-guided Burr Hole Brain Abscess Aspiration

Hassan Allouch
1   Department of Spinal Surgery, Department of Neurosurgery, Zentralklinik Bad Berka, Bad Berka, Thüringen, Germany
,
Majed El Sayed Kassem
2   Department of Neurosurgery, Zentralklinik Bad Berka, Bad Berka, Thüringen, Germany
,
Julianne Behnke-Mursch
2   Department of Neurosurgery, Zentralklinik Bad Berka, Bad Berka, Thüringen, Germany
,
Kay Mursch 
2   Department of Neurosurgery, Zentralklinik Bad Berka, Bad Berka, Thüringen, Germany
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Abstract

Background Ultrasound-guided burr hole biopsies or catheter placements are quick and safe procedures. The use of these procedures for treatment of brain abscesses has been reported, but larger series are missing. The aim of our study was to evaluate the accuracy and safety of the methods.

Patients Twenty-five brain abscess aspirations in 17 patients were analyzed. Fourteen procedures were performed to evacuate abscesses in eloquent regions; another 3 were located deeply in the cerebellar hemispheres.

Results In all the procedures, a histopathologic diagnosis could be established. Only one transient deterioration of a hemiparesis occurred; other operative complications were not observed. Six patients needed more than one operation due to a relapse of the abscess. Two out of three cerebellar abscesses could be cured with one aspiration. Thirteen patients had an excellent outcome, and 2 remained severely disabled. One patient died from cerebritis and another from a neoplasm. In every procedure, a proper visualization of the abscess and monitoring of the penetration and aspiration could easily be performed.

Conclusion Ultrasound-guided burr hole aspiration is minimally invasive, quick, and has a very low complication rate. It offers the advantage to adapt to intraoperatively changing anatomy. The rate of recurrence is not lower than in other treatment modalities.

Keywords

abscess aspiration - brain abscess - burr hole - intraoperative ultrasound - ultrasonography


Publication History

Received: 13 May 2020

Accepted: 25 August 2020

Article published online:
22 February 2021

© 2021. Thieme. All rights reserved.

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