To evaluate the clinical efficacy and safety of stratified drainage in the treatment of suppurative intracranial infection.

The clinical data, treatment outcomes and follow-up of 82 patients diagnosed with suppurative intracranial infection in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from October 1st, 2022 to October 1st, 2023 were analyzed, retrospectively. Categorical data such as gender, type of primary disease and type of infecting bacteria were described as cases (%). Quantitative data, including layered drainage time and infection control time were expressed as medians (interquartile range) [M (P₂₅, P₇₅)], comparisons between groups were performed by Mann-Whitney U test.

All the 82 patients were hospitalized for more than 30 days, and all exhibited multidrug-resistant (MDR) bacterial infection and were treated with stratified drainage for suppurative intracranial infection. The culture results of pus or cerebrospinal fluid were positive before operation, including 78 (95.1%) cases of Gram-negative bacilli infection and 11(13.4%) cases of Gram-positive cocci infection. The number of patients’ systemic drainage tubes was more than 2, up to 6. The incidence of ventricular empyema was 56.1% (46/82), including 38 cases (46.3%) with drainage from the temporal horn of the lateral ventricle, 12 cases (14.6%) with drainage from the fourth ventricle and 19 cases (23.2%) with drainage from the lumbar cistern. The 30 day infection control rate was 91.5% (75/82) and infection control period was [15 (10, 21)] days. After 6-month follow-up, 4 (4.9%) cases died, 1 (1.2%) case had developed a new infection; 57 (69.5%) cases had undergone ventriculoperitoneal shunt procedures.

Through the subdural, intraventricular and subcutaneous multi-catheter combined with layered drainage technology, and dynamic cerebrospinal fluid pressure regulation mechanism, this study verified the significant effect of layered drainage technology in the effective control of cross anatomical level infection and improvement of cerebrospinal fluid circulation disorder, and provided innovative solutions for the treatment of suppurative intracranial infection.