Individualized surgical management of acute intracranial infection-associated hydrocephalus

Objective: This study aims to discuss and summarize surgical treatments for acute intracranial infections with hydrocephalus as a supplement to antibiotic treatment. Methods: A total of 29 patients diagnosed with acute intracranial infection associated with hydrocephalus were divided into three groups for comparison and analysis of surgical interventions and outcomes. Results: In this study, 29 patients in one group underwent surgical treatment, while 28 received various forms of external cerebrospinal fluid (CSF) drainage, with a maximum of 5 drainage procedures. Additionally, 6 patients had Ommaya reservoir implantation, 6 had debridement, and 11 had a hydrocephalus shunt. Among the five patients in Group 1, all underwent shunt device extubation. The statistical analysis revealed no significant difference in surgical modes between the groups, but the outcomes did show a statistically significant difference (χ2 = 6.433, P = 0.040). Conclusion: Individualized and multiple surgeries are needed for acute intracranial infection associated with hydrocephalus. In cases where the infection is secondary to a shunt, the primary surgical approach involves removing the shunt device. In situations where the infection is linked to hydrocephalus following different craniotomies, addressing scalp infection, cerebrospinal fluid leakage, and skull defects is essential. In instances of community-acquired intracranial infection associated with hydrocephalus, continuing drainage of cerebrospinal fluid is imperative.