ORIGINAL
Introdução: Infecções intracranianas permanecem desafios neurocirúrgicos críticos com alta morbidade. Diagnóstico precoce e intervenção cirúrgica imediata são essenciais para desfechos favoráveis. Objetivo: Revisar perfis clinicopatológicos, manejo e desfechos de infecções intracranianas em um hospital nigeriano. Métodos: Este estudo retrospectivo de 6 anos analisou pacientes manejados cirurgicamente utilizando estatística descritiva e inferencial. Resultados: Trinta e dois pacientes incluídos (homem: mulher 3:1; idade 3 meses–73 anos; mediana: 19.5 anos). Pico incidência: 0–20 anos. Fontes identificadas em 20 (62.5%) pacientes; 12 (37.5%) criptogênicas. Sintomas: cefaleia (24.6%), febre (18.4%), convulsões (14.9%) e sensório alterado (14.9%). Quarenta e três lesões tratadas: abscessos cerebrais (41.9%), empiemas subdurais (16.3%) e abscessos epidurais (14.0%) predominaram. Lobos frontal (43.8%) e parietal (31.3%) mais afetados; 43.8% envolveram hemisfério esquerdo. Drenagem por orifício-trépano (71.9%) foi intervenção comum. Volumes: 10–220 mL (mediana: 40mls). Cinco pacientes com culturas positivas (60% Escherichia coli). Em dois meses, desfecho favorável em 25 (78.1%) pacientes e desfavorável em 7 (21.9%). Complicações (n=20): infecções sítio cirúrgico (45%), mortalidades (25%) e recorrências (15%). Escala Coma Glasgow (GCS) admissão previu significativamente desfecho (p=0.016). Conclusão: Embora infecções intracranianas sejam grande desafio na neurocirurgia, maiores escores GCS admissão predizem prognóstico favorável.
Introduction: Intracranial infections remain critical neurosurgical challenges with high morbidity. Early diagnosis and prompt surgical intervention are essential for favorable outcomes. Objective: To review clinicopathological profiles, management, and outcomes of intracranial infections in a Nigerian hospital. Methods: This 6-year retrospective study analyzed patients managed surgically using descriptive and inferential statistics. Results: Thirty-two patients were included (male: female 3:1; aged 3 months–73 years; median: 19.5years). Peak incidence: 0–20 years. Sources were identified in 20 (62.5%) patients while 12 (37.5%) were cryptogenic. Symptoms included headache (24.6%), fever (18.4%), seizures (14.9%), and altered sensorium (14.9%). Forty-three lesions were treated: cerebral abscesses (41.9%), subdural empyemas (16.3%), and epidural abscesses (14.0%) predominated. The frontal (43.8%) and parietal (31.3%) lobes were most affected; 43.8% involved the left hemisphere. Burr-hole drainage (71.9%) was the commonest intervention. Volumes: 10–220 mL (median: 40mls). Five patients had culture-positive collections (60% Escherichia coli). At two months, outcome was favorable in 25 (78.1%) patients and unfavorable in 7 (21.9%). Complications (n=20) included surgical site infections (45%), mortalities (25%), and recurrences (15%). Admission Glasgow Coma Scale (GCS) score significantly predicted outcome (p=0.016). Conclusion: Whereas intracranial infections are still a major challenge in neurosurgery, higher admission GCS scores predict favorable prognosis.
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1Division of Neurosurgery, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Received Mar 12, 2026
Corrected Mar 31, 2026
Accepted May 7, 2026
