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The fundamentals of successful treatment of any disease include early diagnosis, timely treatment, and vigilant monitoring of response to treatment. To accomplish this sometimes-difficult process, it is crucial to employ the means that provide important disease markers, including laboratory parameters and imaging characteristics, in addition to clinical symptoms and signs. A brain abscess, for instance, demonstrates the value of improved medical imaging. Before cross-sectional imaging, the diagnosis of a brain abscess depended heavily on clinical history (usually a history of otitis media) and the presenting symptoms (nonspecific headache, fever, or both). Mortality from abscess decreased dramatically to nearly zero in the post-CT era. One may ask how CT has influenced the treatment of brain abscesses. To answer this question, a thorough understanding of the evolution of a brain abscess is essential. The formation of a brain abscess follows a typical evolution that can be divided into four contiguous stages: early cerebritis (days 13), late cerebritis (days 49), early capsule (days 1014), and late capsule (day 14 or later). The evolution involves the inflammatory responses of the brain to restrain microorganisms from spreading by eliciting local inflammatory cell infiltration and edema, and later, by the formation of a distinct
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Sep 1, 2004
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