Metastatic brain abscess: Complicating inconspicuous pulmonary suppuration in the presence of chronic nontuberculous empyema

Download started.

Metastatic brain abscess

Complicating inconspicuous pulmonary suppuration in the presence of chronic nontuberculous empyema

Robert W. Buxton, M.D.
Robert W. Buxton
Affiliations
From the Department of Surgery, University of Michigan Ann Arbor, Mich. U.S.A.
Search for articles by this author
M.L. White Jr., M.D.
M.L. White Jr.
Affiliations
From the Department of Surgery, University of Michigan Ann Arbor, Mich. U.S.A.
Search for articles by this author

This paper is only available as a PDF. To read, Please Download here.

1.
1. During the years 1934 to 1941, inclusive, 343 cases of empyema have been admitted to the University of Michigan Hospital. Of this group, 132 cases were considered chronic. Six of these patients with chronic empyema died of metastatic cerebral abscess, an incidence of 4.5 per cent.
2.
2. The six cases with their autopsy findings are reported in detail. In four of the cases the previous empyema space was obliterated. Five of the six cases displayed varying degrees of chronic parenchymal pulmonary suppuration. This was considered a more probable source of emboli than the pleural infection.
3.
3. Adequate and dependent drainage of the empyema was established in four of the six cases after admission to the hospital. No definite correlation was noted between manipulation at the empyema drainage site and the onset of cerebral symptoms.
4.
4. In four of the reported cases the cerebral abscess was solitary; in one, multiple, and in one, multilocular. In none of the cases has encapsulation of the abscess been present. All had a purulent meningitis and in two cases rupture of the abscess into the adjacent lateral ventricle occurred.
5.
5. In three cases of brain abscess exploratory craniotomy was done; in two of the cases the abscess was drained surgically, while in one the abscess was evacuated through the exploring needle. Appropriate chemotherapy with one of the sulfonamide compounds was carried out in these three cases.

To read this article in full you will need to make a payment

One-time access price info

Already a print subscriber? Claim online access

Already an online subscriber? Sign in

- Evans W.
The Pathology and Etiology of Brain Abscess.
Lancet. 1931; 1: 1289-1292
- Grant F.C.
The Mortality From Abscess of the Brain.
J. A. M. A. 1932; 99: 550-555
- Google Scholar
- Eagleton W.P.
Brain Abscess.
The Macmillan Company, New York1922
- Google Scholar
- Batson O.V.
The Function of the Vertebral Veins and Their Role in the Spread of Metastases.
Ann. Surg. 1940; 112: 138-149
- Cohen I.
Cerebral Complications of Putrid Pleuropulmonary Suppuration.
Arch. Neurol. & Psychiat. 1934; 32: 174-183
- Nickerson D.A.
Brain Abscess as a Complication of Septic Pulmonary Disease.
New England J. Med. 1935; 213: 228-230
- Crossref
- Google Scholar
- Schorstein G.I.
Abscess of the Brain in Association With Pulmonary Disease.
Lancet. 1909; 2: 843-852
- Google Scholar
- King J.E.J.
Acute Metastatic Brain Abscess.
South. Surgeon. 1936; 5: 407-437
- Google Scholar
Kahn, E. A.: Personal communication, 1942.
- Google Scholar
- Hedblom C.A.
Causative Factors and Treatment of Chronic Empyema.
J. A. M. A. 1923; 81: 999
- Crossref
- Google Scholar

Received: May 15, 1942

Property	Value
Status
Version
Ad File
Disable Ads Flag
Environment
Moat Init
Moat Ready
Contextual Ready
Contextual URL
Contextual Initial Segments
Contextual Used Segments
AdUnit
SubAdUnit
Custom Targeting
Ad Events
Invalid Ad Sizes