Cranial Epidural Abscesses

Abstract

Cranial epidural abscess is a purulent collection developing between the dura mater and the cranial bone. The occurrence of cranial osteomyelitis is not rare. In developed countries, postoperative craniotomy infections remain the most common cause of the disease, whereas in developing nations, otorhinolaryngologic and dental infections have become the predominant sources. Because of the relative isolation of the brain parenchyma and the insidious development of the infection, these abscesses tend to reach a large size at diagnosis. Biologic parameters may be elevated but are nonspecific. Imaging studies are important tools in the initial diagnosis (biconvex appearance) and in the monitoring of treatment results. The abscess must be evacuated to eradicate the infection. Treatment of the primary source of suppuration can also be performed in the same intervention in most patients. The dura should not be opened, to avoid any meningitis or deeper suppuration. The outcome is related to the delay in diagnosis and to the severity of infection, especially deeper intracranial complications and extensive cranial osteomyelitis.