Post-craniotomy infections: A point-by-point approach

作者：Giovanni Carone, Marta Bonada, Evelyn Gisell Belotti, Eugenia D'angeli, Annica Piccardi, Fabio Martino Doniselli, Guido Gubertini, Cecilia Casali, Francesco DiMeco, Massimiliano Del Bene · 发表于：Brain and Spine · 年份：2025 · DOI：10.1016/j.bas.2025.104193 · 被引用次数：11 · 研究领域：Head and Neck Surgical Oncology、Surgical site infection prevention、Traumatic Brain Injury and Neurovascular Disturbances

Post-craniotomy neurosurgical infections (PCNIs) significantly challenge daily neurosurgical practice, affecting patient outcomes and imposing economic burdens on healthcare systems. Despite advances in surgical techniques and infection control protocols, PCNIs still contribute to surgical-related morbidity and mortality. To address these unresolved questions through a comprehensive literature review. We conducted a detailed literature review using the keywords "Infection, Craniotomy, Neurosurgery," on PubMed, which yielded 2330 articles. Out of these, 171 were selected, based on relevance, and rigorously reviewed. The review aimed to answer thirteen major questions stemming from the management of PCNIs. PCNI incidences range from 0.7% to 8%, predominantly caused by gram-positive bacteria, especially Staphylococcus species. Significant risk factors identified include CSF leakage, emergency surgery, and certain tumour types, with infections typically manifesting post-discharge. Diagnostic approaches integrate clinical, radiological, and laboratory assessments, with advances in molecular diagnostics showing promising precision. While antibiotic prophylaxis remains effective, emerging resistance warrants cautious application. Surgical intervention is often indispensable for managing organ-space infections, with a trend towards bone flap preservation and one-step cranioplasty procedures in certain cases. The management of PCNIs remains a major challenge. There is a critical need ...