title: Taming an old enemy: a profile of intracranial suppuration.
abstract: Intracranial suppurative disorders (ICSDs; brain abscess, empyema, and purulent ventriculitis), have been a scourge through the ages and attempts at curative surgery, as for cranial trauma, are considered to be one of the first true neurosurgical interventions performed. ICSDs, seen initially as a consequence of poor socioeconomic conditions and neglected otorhinogenic infections, predominantly manifest today as postsurgical complications, and/or in immunocompromised patients where they continue to result in significant neurologic morbidity and death. The reduction in the incidence of "old world" classic ICSDs can be attributed to the modernization of society, driven inter alia by a shift from an agricultural to an industrial economic society. It can also be coupled with pivotal achievements in public health and the dramatic developments in medicine in the 20th century. This trend was first noted in developed countries but now, with improved socioeconomic circumstances and globalization of medical technology, it is occurring in the developing regions of the world as well. Although ICSDs have undergone a metamorphosis in their clinical profile and despite their rarity in contemporary "developed world" neurosurgical practice, they still have undoubted potential for fatal consequences and continue to pose a significant challenge to the 21st-century neurosurgeon.
authors: Department of Neurosurgery, Wentworth Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa. narendra.nathoo@gmail.com
authors: Narendra
authors: N
authors: Nathoo
authors: Pradeep K
authors: PK
authors: Narotam
authors: Sameer
authors: S
authors: Nadvi
authors: James R
authors: JR
authors: van Dellen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000266:history / Q000382:microbiology / Q000628:therapy*; D001927:Brain Diseases / Q000266:history / Q000382:microbiology / Q000628:therapy*; D058565:Cerebral Ventriculitis / Q000266:history / Q000382:microbiology / Q000628:therapy*; D004653:Empyema / Q000266:history / Q000382:microbiology / Q000628:therapy*; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D013492:Suppuration / Q000266:history / Q000382:microbiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents