Aspiration or extirpation in cerebral abscess surgery?

The author carried out CT investigation of 11 patients who recovered after cerebral abscess operation. The finding established in all cases was a hypodensic area of various extensions, which, in 4 patients, made the impression of pseudocysts. Large pathologic lesions were found mainly in the patients in whom healing was complicated by relapse. Surprisingly, rather extensive pathologic changes in the patients were found which were cured by so-called "minimalized surgical intervention". The author imputes these changes to the remaining granulation tissue of the abscess capsula, which worsens conditions for healing. Aspiration is suitable mainly in cases in which the abscess is not -- or only slightly encapsulated. Preoperation CT scans cannot establish exactly the presence and eventual thickness of the capsula. The establishment relationship of the kind and extent of operation to the extent of later cerebral tissue changes in CT findings requires further observation and verification in a larger group of patients.