The importance of computed tomography findings in the management of intracranial infections: experince at Mulago Hospital

ABSTRACT

Mulago Hospital recently acquired a computed tomography (CT) scanner. Intracranial infections arehighly prevalent in third world countries; more so in the AIDS era. CT isa useful non-invasive method of investigating intracranial infections. No data on the value of CT and intracranial infections is available from Uganda and the East African region. We carried out a cross-section descriptive study to evaluate the role of CT in these patients presenting at Mulago Hospital. The specific objectives were to ascertain the frequency ofa various intracranial infections; describe their CT pattern and determine the role of CT in choosing the optimal therapeutic approach. The commonest group of infections were cerebral abscesses (44) which included pyogenic; tuberculous and toxoplasma abscesses; followed by meningitis of variable aetiology (28) and encephalitis (16). CT findings suggestive of pyogenic abscesses and empyaema were invariably an indication for surgery. Appropriate cosnservative therapy was administered in the other patients based on the CT scan together with the relevant clinical and laboratory findings. Theis article illustrates the fact that a good CT characterisation of lesions gives the clinician a working diagnosis on which his therapeutic approach can be based