Management of a large superficial brain abscess with repeated aspirations.

Management of brain abscesses is still an issue of debate. Large superficial abscesses should be totally extirpated through a craniotomy. We present a case of a 66-year old man with a brain pyogenic abscess, without neurological symptoms and signs, without positive cultures, larger than 4cm in size, located superficially who was treated successfully by two repeated aspirations without intracavitary application of antibiotics. We conclude that it is effective to treat a large superficial in capsular stage brain abscess with repeated elective aspirations, since the clinical picture of the patient is mild.