THIS is a study of 4 consecutive cases of acute subdural brain abscess successfully treated by surgical intervention and penicillin (table). Prior to the advent of chemotherapy and penicillin this fulminating condition was almost invariably fatal and was rarely diagnosed during life. Since the surgical management (drainage) has remained essentially unchanged, we must attribute this striking reduction in mortality to the use of antibiotics and sulfonamide drugs. In the next few paragraphs consideration will be given to a historical review of the condition, the structure of the subdural space, pathogenesis, pathologic aspects, clinical manifestations and treatment of the acute subdural abscess.
In 1699 De LaPeyronie1 performed the first successful operation for a subdural abscess. His patient sustained a head injury with fracture in the left parietal region and contusion of the overlying scalp. Although asymptomatic for twenty-five days, he began to show increasing visual weakness and disturbance