Analysis of brain abscess after penetrating craniocerebral injuries in Vietnam

A population of 1221 patients from the Vietnam War with penetrating craniocerebral trauma was analyzed. Thirty-seven cases of brain abscess were documented (incidence, 3%). This sequela occurred more frequently in association with extensive, deep penetrating injuries; deep, prolonged coma; cerebrospinal fluid fistulas; wound infections; facio-orbital cranial/air sinus injuries; and retained bone fragments. The mortality rate was 54%, and, of the patients who survived, 82% had significant morbidity. This is the last large population study of brain abscess after penetrating craniocerebral trauma before the availability of computed tomographic scanning and more comprehensive coma care. It should serve as base line data against which we can measure improvement.