Management and Outcomes of Pediatric Focal Intracranial Suppurations: A Single-Center Retrospective Analysis of 49 Cases

Background: Focal intracranial suppurative infections are serious and potentially life-threatening conditions in children. The effectiveness of different management approaches for these conditions has not been fully evaluated. This retrospective analysis aims to highlight a single-center experience in the diagnosis, management, and outcomes of pediatric focal intracranial suppurations (FIS). Materials and Methods: A single-center retrospective analysis of 49 children managed with FIS was performed. The data collected included clinical presentation, pre- and post-operation neurological status, radiological imaging, predisposing factors, anatomical location, surgical history (number and type of surgical techniques), microbiology, antibiotic therapy, and complications. Results: Parenchymal brain abscesses were the most prevalent (46.94%), followed by subdural empyema (26.53%), and epidural abscess (26.53%). Direct contact from adjacent cranial infections, notably sinusitis, was the primary predisposing risk factor (59.18%). Clinical presentations encompassed fever, headache, focal neurological deficits, and seizures. Antibiotic therapy was administered to all patients, and surgical treatment was performed in 81.63% of cases. The median hospital stay was 23.5 ± 15.37 days. No permanent neurological deficits or mortalities were recorded. Follow-up imaging at 6 months revealed no residual lesions. Conclusion: This study highlights the importance of an interdisciplinary approach to the management of FIS. The findings underscore the significance of early diagnosis, appropriate surgical interventions, and individualized antibiotic therapy in achieving favorable neurological outcomes. The results of this single-center experience contribute valuable insights to guide future clinical decision-making and improve the management of these pathologies in children. © 2025 Elsevier B.V., All rights reserved.