A review of 130 children with brain abscesses treated over 21 years is reported from Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey. Four (3%) were infants, 45% were aged 3-8 years, and 30% were 6-8 years. The incidence decreased between ages 8 and 18 years. Chronic ear infection with mastoiditis occurred in 28 (21%) and congenital heart disease in 26 (20%). Infants had meningitis or ventriculitis. The abscess was supratentorial in 113. In children with congenital heart disease, the parietal lobes were commonly involved with a left-sided predilection (77%). Multiple abscesses occurred in 17 (13%). Primary or secondary excision was used in 74. The initial surgical procedure was aspiration in 71. Staphylococcus, Streptococcus and Proteus were the predominant microorganisms. Cephalosporins were used only recently and penicillin and chloramphenicol were the antibiotics used in earlier cases. Mortality was 15% overall, but 6% in the last 5 years and 0 in the last 3 years. Mortality in infants was 50%. [1]

COMMENT. The medical cure of a brain stem abscess and serial brainstem auditory evoked potentials are reported from the Department of Pediatrics, Chang Gung Memorial Hospital, 199 Tung-Hua N. Road, Taipei, Taiwan, Republic of China [2]. A 9 year-old girl with tetralogy of Fallot was cured after 6 weeks of parenteral antibiotic therapy, without surgical intervention. The initial brainstem auditory evoked potential showed poor demonstration of right waves IV and V, and delay of right wave III and left wave V. Serial follow-up showed improving latencies and wave forms but persistent abnormalities on the right side. The patient presented with a right-sided ptosis, abducens palsy and peripheral facial palsy and left hemiparesis. CT showed a hypodense lesion in the brain stem. Vancomycin and chloramphenicol were the antibiotics used in treatment.