Management of intracranial suppuration in Bahrain

ABSTRACT

Sixteen cases of intracranial suppuration, 13 brain abscess and 3 subdural empyema treated over the last 10 years, were analyzed. All the cases were below 40 years of age with almost equal distribution in each decade. Headache, vomiting, fever and seizures of short duration were common presenting symptoms. Common signs included obtundation, papilloedema and focal deficits. Middle ear infection was the commonest primary source. In 75% cases suppuration was located supratentorially with temporal region as commonest site. The commonest organism grown was staphylococcus aureus. All patients underwent aspiration of pus followed by primary 5 cases or secondary 8 cases, excision of abscess capsule and irrigation of empyema cavity. Only one patient [6%] died. All other 15 cases are well and four of them require anticonvulsant therapy for control of seizures. Prompt surgical drainage is critical adjuvant to medical treatment of brain abscess and subdural empyema. CT Scan is invaluable in the initial diagnosis and follow up of these cases