Markedly enhances rate of recovery and lessens duration of antibiotic requirement. Recommended in traumatic abscesses to debride the area, and in fungal lesions because of their slow response to drugs. Slow progression of symptoms have better prognosis. Direct extension has better prognosis than metastatic. Neurological condition of patient before operation is the most important contributing factor in mortality.
Death usually results from rupture of abscess into ventricle or subarachnoid space.
View in this frame View in new window Non-contrast CT image on left demonstrates very subtle edema in the right occipital lobe and increased density within the right occipital horn. This patient presented with rapidly worsening headache, fever, and somnolence. A ventriculostomy was urgently placed. The ICP was greater than 30cm and the CSF very cloudy. The density in the occipital horn represents pus that has extended from the abscess into the ventricle.