Surgical Management and Outcomes of Intracranial Abscess and Subdural Empyema in a Tertiary Hospital in Northwestern Nigeria: A Two-Year Retrospective Study

Yahaya Abubakar; Aliyu Koko Muhammad; Ali Lasseini

doi:10.5455/EJMID.20260319080110

Abstract
Background: Intracranial abscesses and subdural empyema predominantly affect children and adolescents in our setting. Early diagnosis, prompt surgical intervention, prolonged antibiotic therapy, and management of the primary infection source are critical for favourable outcomes.
Objective: This study aimed to describe the demographic profile, clinical presentation, causes, surgical treatment, and outcomes of patients managed surgically for intracranial abscess and SDE at a tertiary hospital in Sokoto, Nigeria.
Methods: A retrospective review was conducted on patients treated between January 2022 and January 2024 at the Regional Neurosurgery Centre, Usmanu Danfodiyo University Teaching Hospital. Data from case notes and operative records were analysed using SPSS version 25.
Results: Fifteen patients, aged 5–46 years, underwent surgery, with most (53.3%) between 11 and 20 years. Males predominated (2.75:1). Common symptoms were seizures, hemiparesis, headache, and mixed presentations. Most lesions were supratentorial. A brain abscess constituted 67% of cases, while a subdural empyema accounted for 20%. Sinusitis was the leading cause, followed by head injury and otitis media. Burr hole aspiration was the most frequently performed procedure. Positive cultures were identified in 26.6% of patients, mainly Staphylococcus and Streptococcus species. Recurrence occurred in three patients during follow-up.
Conclusion: Early diagnosis and surgery improve intracranial infection outcomes.

Key words: Brain abscess; subdural empyema; burr hole aspiration; craniotomy; sinusitis; intracranial infection