Outcomes and Surgical Approaches for Cranial Infections Necessitating Craniotomy or Craniectomy: A Retrospective Analysis
By
Daniel W. Griepp
Shivum Desai
Heather Heitkotter
Rabia Ahmed
Avery Roe
Bryce K. Sarcar
Ishan Perera
Joshua Caskey
Jeffrey P. Turnbull
Julio Rosado Philippi
Elise J. Yoon
Ammar Alsalahi
James Dragonette
Anna T. K. Griepp
Clifford M. Houseman
Prashant Kelkar
Chad F. Claus
Boyd F. Richards
Daniel A. Carr
June 22, 2026
Clinical Scorecard: Outcomes and Surgical Approaches for Cranial Infections Necessitating Craniotomy or Craniectomy: A Retrospective Analysis
At a Glance
Category Detail
Condition Cranial infections requiring surgical intervention Key Mechanisms Infections include surgical site infections (SSI) and spontaneous infections like subdural empyema and intraparenchymal abscess. Target Population Patients aged 18 years and older undergoing craniotomy or craniectomy for cranial infections. Care Setting High-volume neurosurgical center
Key Highlights
43 patients included in the study with a mean age of 55.5 years. Most common pathogens isolated were Cutibacterium acnes, Staphylococcus aureus, and Streptococcus intermedius. 65.8% of evaluable survivors achieved a good outcome (mRS 0–3) at median 11-month follow-up. Higher Charlson Comorbidity Index associated with poor outcomes. Patients with SSI had a significantly higher rate of craniectomy. Guideline-Based Recommendations
Diagnosis
Diagnosis of SSI guided by CDC guidelines, requiring evidence of infection post-surgery. Management
Surgical intervention often necessitates craniotomy or craniectomy, with prolonged courses of broad-spectrum antibiotics. Monitoring & Follow-up
Vigilant monitoring for recurrence is essential in managing cranial infections. Risks
Poor outcomes associated with higher comorbidity and underlying aggressive pathology. Patient & Prescribing Data
Adults aged 18 and older with cranial infections.
Median duration of intravenous antibiotics was 6 weeks.
Clinical Best Practices
Consider pre-existing comorbidities when assessing functional outcomes. High culture yield regardless of preoperative antibiotic initiation. Related Resources & Content
