Brain abscess evacuation can be done via needle drainage (stereotactically) or using an open craniotomy (similar as for a bleed). In this case, several bone holes may be drilled using a drill, and using a different drill bit, these are connected to remove a small “bone flap.” The underlying dura (or lining of the brain) is then opened, to access the brain in the safest method. Great care must be taken in brain abscess evacuation, since rupture into the fluid filled chambers of the brain (called ventricles) can lead to high life-threatening risk. We have treated abscesses more precisely using navigation (frameless stereotaxy), which allows us to pinpoint the location.
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