One hundred cases of brain abscess presenting between 1974 and 1984 are reviewed. The overall mortality was 20%, 98 cases were actively treated with a peroperative mortality of 14%. The results are compared to Garfield's 1969 series, drawn from similar clinical material. Changes in presentation and outcome are described. A significant improvement in survival (p less than 0.001) has occurred following the introduction of computerised tomography (CT Scan) which permits the rapid diagnosis and accurate localisation of intracranial sepsis. As the basic therapeutic regime remains unchanged (burr hole aspiration and appropriate antibiotic treatment), other aspects of management have been examined, leading to the suggestion that CT Scanning has made a major contribution to the reduction in mortality.

Twenty four cases of subdural empyema are reviewed. The overall mortality was 17%, 18 patients were managed by burr hole and five by craniotomy or craniectomy. Antibiotic therapy was commenced once pus had been evacuated. Infection of the paranasal and mastoid sinuses was the commonest aetiological factor. Aspiration of pus through burr holes is the recommended surgical procedure with low mortality and morbidity, when combined with early diagnosis and aggressive chemotherapy.