Craniotomy versus Burr Hole Aspiration for Superficial Brain Abscess. a Single Institutional Perspective from a Low-income Country

Introduction: To compare craniotomy versus burr hole aspiration for superficial brain abscess.
This study is from low socioeconomic region hospital but now adays due to recent advancements and available resources, the results might be different in developed countries.

Methods: A comparative study was conducted on patients having superficial brain abscess. The subjects were
divided into two groups and comparison was done between burr hole aspiration and craniotomy
procedures. Data was collected on the participant’s age, sex, presenting complaints, duration of sign
and symptoms, various predisposing factors, location of brain abscess on imaging (CT Head) and
outcomes of brain abscess in terms of clinical improvement, recurrence, and mortality.

Results: The mean age of the patients in our study population was 26.93 +-12.44. About 59.2 % (n=45) for
males while 40.8% (n=31) were females. The median GCS at presentation was 13. The mean duration
of the symptom was 14.90+-5.67 days. Our data indicated that complete radiological resolution was
significantly higher for craniotomy (P < 0.01). There was also a statistically higher rate of recurrence
for burr hole aspiration (P=0.032), however there was no statistically difference in GCS at discharge
and follow up.

Conclusion : Our study shows that craniotomy appears to be slightly better in terms of clinical outcomes in
superficial brain abscesses, however, the utility of burr hole aspiration cannot be excluded and in a
limited resource setting as ours, it proves to be effective management option.