Early multimodality treatment of intracranial abscesses.

Abstract

The treatment of brain abscesses remains one of the success stories of contemporary neurosurgery; what began as a nearly uniformly fatal disease at the turn of the 20th century has become a largely curable ailment through the use of operative and pharmaceutical intervention. Following institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the surgical files of the Johns Hopkins Hospital, 1896 to 1912, were reviewed. A total of six patients were operated on for intracranial abscesses. Three patients died during their admission, the remaining three were discharged with a condition listed as "improved" or "well." Cushing employed a variety of operative drainage techniques for intracranial abscesses and implemented an early antibacterial agent to provide adjuvant treatment in one patient. Although these cases demonstrate a 50% mortality rate, they provide insight into the challenges faced by neurosurgeons treating intracranial abscesses at the turn of the 20th century.