Nonsurgical management of focal intracranial infection

Fourteen patients with focal suppurative intracranial inflammatory disease were initially treated nonsurgically. Eleven received antibiotics and corticosteroids, and three received only antibiotics. In 12, there was both clinical and computerized tomography (CT) resolution. In two patients, evolution to ring-enhancing encapsulated lesion was subsequently proved to be an encapsulated abscess that required surgical drainage, after which there was a good clinical outcome. In four patients, complete CT resolution was not evident for 2 to 6 months after completion of antibiotic therapy, although the patients had become neurologically asymptomatic prior to this.