The management of cerebellar abscess since the introduction of CT scanning

Sixteen patients with surgical infection of the posterior fossa are presented. There were 14 patients with cerebellar abscess, one patient with a solitary posterior fossa subdural empyema, and another with a combined cerebellar abscess and subdural empyema. Two of the cerebellar abscess patients also had supratentorial infections. The presenting features, aetiology, radiology and bacteriology are discussed with particular reference to differences in abscess re-accumulation, and outcome between those managed by aspiration and excision. We have been unable to show that either method of treatment is superior to the other. An overall mortality rate of 19% was achieved; however, for those with parenchymal cerebellar abscesses this was reduced to 13%. We conclude that burr hole aspiration with regular CT is a satisfactory method of treatment for cerebellar abscess.