Intracranial Suppurative Disease

Abstract

To Editor.— The paper on Intracranial Suppurative Disease (218: 1542, 1971) would lead one to believe that something new had been developed to obviate intracranial surgery for brain abscess. It should be pointed out that a focal intracranial lesion is not necessarily surgical lesion. The fact that carotid angiograms were normal in six cases initially bears this out. However, in cases 3 and 7, when carotid angiography disclosed a mass lesion, surgery was carried out in conventional manner. In case 1, it is stated that the strongest deterrent to craniotomy was fear of hemorrhage. I could see no indication for craniotomy with normal angiogram and sonoencephalogram. Competent hematologists assure me that plasma thromboplastin component deficiency can be controlled readily by administration of factor IX at time of surgery. In short, this article emphasizes a dogma taught me as a resident: ... in central nervous system sepsis mass