Epidural abscesses in Africa

Paradural suppurations (epidural and subdural empyema) are serious infections of the CNS that frequently have a grave prognosis. The review by Pradilla and co-authors 1 in the March issue of The Lancet Neurology is a good overview of epidural abscesses that succinctly discusses management strategies for patients with cranial or spinal epidural abscesses. I agree with Pradilla and co-authors that restricted access to health facilities is an important contributor to the poor outcome of patients with epidural abscesses in Africa. Medical practitioners need to educate the population actively about the various risk factors, particularly adequate treatment of infections in the paranasal sinuses, which are a leading cause of intracranial suppuration but are often not regarded as a serious risk factor by the general population. Sickle cell disease 2