The authors report the management and follow-up of 20 patients with severe postoperative intracranial infections, abscesses and/or empyemas. Clinical neurological diagnosis was difficult in patients with deficits resulting from the first operation but over half the cases had an inflammatory reaction in the operated zone. CT scan showed that the infection was not limited to a single site (e.g. the subdural area) but was more diffuse in the majority of cases. Antibiotics were given alone in 10 patients and in association with empyema aspiration or reoperation in the other 10 patients. There were two fatalities but the other patients made a generally good functional recovery.
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