Resident Physician Allegheny Health Network Pittsburgh, Pennsylvania, United States
Introduction: Cerebral abscesses are an increasingly more common neurosurgical pathology with no strong clinical or radiographic categorization of high vs low risk abscesses. This information would be key to triaging patients appropriately and providing accurate prognostic information.
Methods: A retrospective review was performed of all cerebral abscesses at our institution from 2016-2021. Post surgical abscesses and patient's with concurrent cerebral malignancy were excluded. An MRI Brain with and without contrast was required prior to the initiation of treatment to be included in the study. Detailed clinical and radiographic information were recorded for each patient, and a quantile multilinear regression analysis was used for data analysis.
Results: A total of 35 patients were identified for inclusion in the study. Through our regression analysis, T2 hypointense capsule rim thickness in millimeters was the only radiographic parameter correlating with mRS at discharge (-0.599, p = 0.049) . The range of capsule thickness in our sample was from 1 mm to 4.6 mm. The only clinical factor that correlated with mRS at discharge was IVDU (3, p = 0.0262). No other clinical radiographic factors were significant in predicting functional outcomes at discharge.
Conclusion : The data demonstrates that functional outcomes can be predicted in patients with cerebral abscesses utilizing T2 Capsule Rim Thickness on initial presenting MRI Brain and the presence of IVDU in the patient's medical history. Each 0.599 mm increase in capsule thickness correlated with a 1 point decrease in mRS, suggesting thicker abscess capsules had better functional outcomes at discharge. A larger sample size would be useful in helping confirm the findings in this study.
