Intracranial Abscess

Lorenz Lampl, G√ľnter Frey

Dept. of Anesthesiology and Intensive Care Medicine Federal Armed Forces Hospital D-89070 Ulm / Germany

Abstract: Intracranial abscesses (cerebral abscess, epi- and subdural empyema) are described in the literature to have an overall mortality of 10 - 36 %. A high percentage of the surviving patients is persistently suffering from neurological deficits. Starting from on anecdotal case, up to now, our group treated 21 consecutive unselected patients with intracranial abscesses (ICA) by adjuvant hyperbaric oxygen therapy (HBO). We found a 0.0 % mortality with only one patient remaining severely handicapped.

Based upon these facts, both the ECHM and UHMS have approved the use of HBO when, at least, one of the following criteria is met: multiple abscesses; abscess in a deep or dominant location; compromised host; in situations where surgery is contra-indicated or where the patient is a poor surgical risk; where there is no response or further deterioration in spite of standard surgical (e.g. 1-2 needle aspirates) and antibiotic treatment

Keywords: Intracranial abscess, mortality, anaerobic bacteriology, intracranial pressure, peri-focal brain swelling, adjunctive HBO

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