The treatment of brain abcess / Paul C. Bucy.

  • Bucy, Paul C. (Paul Clancy), 1904-1992.
Date:
[1938?]
Catalogue details

Licence: In copyright

Credit: The treatment of brain abcess / Paul C. Bucy. Source: Wellcome Collection.

    1/38 (page 961)
    VOL. 108 DECEMBER, 1938 No. 6 THE TREATMENgrpF BRAI C. Bucy, M.D Chicago, III. FKOM THE DIVISION OF NEURQ^GY AND NEUROSURG^ERY OF THE UNIVERSITY OF CHICAGO, CHICAGO, ILL. The most appropriate method of (pealing with abscesses of the brain is still the subject of discussion. Any method which has proved reasonably successful merits consideration. The present report is based upon a series of 17 consecutive cases in which the abscess has been dealt with surgically (Table I). Of the 17 cases, four were cerebellar and 13 were cerebral.f Of the former none died. Of the cerebral cases five died (29.4 per cent). In three of these five fatal cases the infection metastasized from the lung. In Case 2, there were multiple areas of infection throughout the body, in the chest, abdomen and pelvis, and a culture of the blood revealed Staphylococcus aureus, the organism found in the cerebral abscess. Tbe patient improved greatly following drainage of a large abscess in the right parietal area, only to become unexpectedly stuporous on the eighth postoperative day and die within 24 hours. Knowing the tendency for abscesses which originate by metastasis from the lungs to be multiple, it was believed that death was prob¬ ably the result of one or more other intracranial abscesses. Unfortunately, necropsy was refused. In Case 3, a child of 18 months, where the infection also arose from the lung, necropsy revealed a total of seven separate, intra¬ cerebral abscesses and a leptomeningitis. In Case 5, the child, age 3, was admitted in extremis, and died within less than 24 hours after admission and operation. Necropsy revealed an enormous abscess of the left parieto¬ occipital region which had ruptured into the lateral ventricle and produced a diffuse leptomeningitis, in all probability prior to the operation. It is difficult to see how any type of treatment could have benefited these three cases (unless in Case 5, a combination of drainage and the administration of sul- * Presented before the Chicago Surgical Society, May 6, 1938. Submitted for publi¬ cation April 21,-1938. t Since preparing this paper an additional case has been treated and has recovered. The patient (F. S.) was a female, age 4, who had developed a right cerebellar abscess, apparently secondarily to a transitory right otitis media. Hemolytic Streptococci were recovered from the abscess. It was successfully treated with a single aspiration and the subsequent administration of sulphanilamide.