Absceso cerebral

Hernando Alvis–Miranda, Juan José Gutiérrez–Paternina, Gabriel Alcalá–Cerra, Sandra Milena Castellar–Leones, Luis Rafael Moscote–Salazar

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Resumen

OBJETIVO: Revisar la epidemiología, etiología, fisiopatología, diagnóstico y tratamiento del absceso cerebral según la evidencia más recientemente disponible.

ADQUISICIÓN DE LA EVIDENCIA: Las referencias se identificaron mediante la búsqueda en PubMed de las publicaciones de los últimos 5 años en inglés con el término: “Brain abscess”.

RESULTADOS: El absceso cerebral constituye una forma focal y dinámica de supuración intracraneal que representa una emergencia médica. Con alta incidencia en países en vía de desarrollo, son un problema de salud mundial, que arrastra alta morbimortalidad y una alta carga económica para los servicios de salud. La mortalidad por esta causa ha disminuido notoriamente de 50 % a menos del 20 %, gracias a la introducción de la tomografía computarizada, que permite hacer diagnóstico más tempranos y con ubicación precisa. Con el advenimiento de las terapia antibióticas en general, las Streptococcus spp. se han convertido en los organismos más comúnmente aislados. La distinción etiológica puede realizarse teniendo en cuenta la el origen del absceso y el estado inmunológico del paciente. Actualmente las herramientas diagnósticas más importantes son las modalidades de neuro–imágenes. Para su manejo se requiere un enfoque multidisciplinario. Se aborda en esta revisión la epidemiología, fisiopatología, etiología, contexto clínico, diagnóstico, tratamiento, mortalidad y pronóstico de los abscesos cerebrales.

CONCLUSIONES: El absceso cerebral sigue siendo una entidad seria con alto riesgo de mortalidad, del cual se espera se haga más difícil el tratamiento, por la creciente población inmunocomprometida y de edad avanzada.

Palabras clave

Absceso encefálico; Craniotomía; Imagen por Resonancia Magnética; Infecciones bacterianas del Sistema Nervioso Central; Neurocirugía; Técnicas Estereotáxicas

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