Intracranial Suppurative Disease

Abstract

The limiting factor in the prognosis of patients with intracranial abscess is the irreversible damage done before treatment is instituted. Six cases of documented focal intracranial infection in which abscess development was either aborted or reversed stress the feasibility of early diagnosis and appropriate antibiotic therapy without surgery. Early diagnosis is based on severe headache, with or without focal neurologic symptoms, in patients with extracranial suppurative focuses, and is confirmed by focal electroencephalographic changes. Even without bacteriologic examination of cranial contents, penicillin G potassium and tetracycline hydrochloride or chloramphenicol sodium succinate can confidently be used, unless a resistant bacterium has been identified in the blood or extracranial focus. Focal signs appearing early in treatment do not necessarily presage failure, but deterioration in level of consciousness probably indicates the need for surgical decompression. Long-term prognosis following nonsurgical treatment is good.