Aims:
The aim of our study was to present the last 3 years case series of intracranial infections, their major clinical manifestation, radiological distribution and surgical management
Background:
Intracranial infections are serious and life-threatening medical conditions. The spectrum of intracranial infections includes meningitis, encephalitis, ventriculitis to cerebritis/brain abscess and subdural empyema.
Methods:
We included 41 patients in our studies out of 45 total cases between 2017(Jan) to 2020(May). Patients information were found from department records and operative register. These patients were confirmed after surgical procedures. In our studies, 11 patients were female and 30 patients were male. The mean age distribution was 7month to 67 years. Out of 41 patients, 33 had intracerebral abscesses (21 solitary abscesses and 12 having multiple abscesses) and 8 had subdural empyemas. All patients underwent craniotomy and some craniectomy as surgical procedures followed by an antibiotic regimen average of 4-6 weeks including at least 2weeks injectable based on culture or empirical.
Results:
Our results showing more predominant in the male gender and most age group involved were third and fourth decade. Majority of cases no definite infectious agents were identified which constitute about 56%. Fungus and tubercular causes constitute 2.4% and 9.7%. The most common lobe involved was the temporal lobe and the majority of patients underwent craniotomy with complete/partial capsule excision. Predominate clinical manifestations were headache(78%), fever(53.6%), Nausea/Vomiting(29.2%), Neurological deficits(19.5%), Seizure(19.5%). Different location of intracranial infections are as follows Solitary brain abscess in 21%, multiple brain abscess in 12% and subdural empyema in 19.5%. Following surgery, 63.4% were complete symptomatic free and 24.3% clinically improved and death in 12.1%
Conclusion:
Surgical treatment is the gold standard treatment available for brain abscess and craniotomy still holds the best method to address brain abscess and in particular to developing countries like India in terms of feasibility and cost-effectiveness.
Key words: Brain abscess, subdural empyema, craniotomy, intracranial infection
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