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Editor's Notes

1. Not exclusive, can occur concurrently Percentages in children (Hicks et al, 2011)
2. Also incidence of neurologic sequelae such as hearing loss and seizure disorder.
3. Will likely need antibiotics for 4-8 weeks; usually vancomycin and 3rd or 4th generation cephalosporin Prophylactic seizure therapy not necessary unless there’s an associated subdural abscess.
4. Generally unilateral
5. May have mood swings and behavioral changes with frontal lobe involvement Worsening headache with meningismus suggests possible rupture of the abscess.
6. Antibiotic regimen is typically 6-8 weeks; typically ceftriaxone, vancomycin or nafcillin, and metronidazole Corticosteroid use is controversial. Steroids can retard the encapsulation process, increase necrosis, reduce antibiotic penetration into the abscess, increase the risk of ventricular rupture, and alter the appearance on CT scans. Steroid therapy can also produce a rebound effect when discontinued. If used to reduce cerebral edema, therapy should be of short duration. The appropriate dosage, the proper timing, and any effect of steroid therapy on the course of the disease are unknown. The procedures used are aspiration through a bur hole and complete excision after craniotomy. Aspiration is the most common procedure and is often performed using a stereotactic procedure with the guidance of CT scanning or MRI.