Cerebral abscess in children.

We reviewed 94 consecutive episodes of pyogenic brain abscess seen at Children's Hospital Medical Center, Boston, between 1945 and 1980. After 1970, the mortality as reduced from 36% to 14%. Predisposing factors included congenital heart disease, otitic and sinus infections, closed head injuries, and cystic fibrosis. There were seven patients younger than 5 months of age. In one patient with Fallot's tetralogy, an abscess recurred at the site of retained thorium dioxide (Thorotrast) after an 11-year interval. The continuing substantial mortality is attributed to the presence of coma at the time of treatment, hemorrhagic complications of tapping abscesses, and the location of abscesses in deep brain structures. The early detection and successful treatment of brain abscesses in children remains a clinical challenge.