CEREBELLAR ABSCESSES
The abscesses of the cerebellum are most often located in the hemispheres and are caused by suppurative otitis or mastoiditis. The cerebellar surface is usually found adherent to the pyramid of the temporal bone. These abscesses are treated surgically by punctures and drainage (Fig. 7-13).
Puncture and evacuation of the abscess are carried out in the following way: under local anaesthesia a burr hole is made 3 cm laterally and below the external occipital protuberance that is enlarged 2 - 3 cm in diameter. The dura is opened in the usual way. A puncture is made through this burr hole, and, if the cannula enters into the abscess cavity, the content is completely evacuated. The abscess cavity is washed with copious amounts of saline and antibiotics, until a clear washing fluid is obtained. The place of puncture is coagulated and the wound is closed in layers with the usual drainage left. Excision of cerebellar abscesses can be required in recurrences. Complete control of the otological infection should be obtained in all cases.