Neurosurgical perspective on Pott's puffy tumor management of both adult and pediatric patients in Tasmania, Australia: illustrative cases.
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BACKGROUND: Pott's puffy tumor (PPT) is a subperiosteal abscess formation of the frontal bone with associated osteomyelitis. Few studies have described the range of neurosurgical techniques used or compared patient outcomes across different management strategies. These illustrative cases aim to compare the clinical course, surgical approaches, and outcomes in 4 pediatric patients and 1 adult patient with PPT. OBSERVATIONS: The authors report 5 illustrative cases of PPT in Tasmania. There were 3 males and 2 females with a mean age of 11 years. All patients presented with frontal headache, fever, and forehead edema after a trial of oral antibiotics in the community. One case resolved with medical therapy alone, while the remaining 4 required neurosurgical intervention. Among the operative cases, 1 patient underwent multiple procedures including a bifrontal craniectomy. Two patients underwent a frontal surgical incision and drainage, and 1 patient underwent needle aspiration. Fortunately, there were no long-term sequelae for any of the patients. LESSONS: The failure of medical management underscores the need for prompt neurosurgical referral with various surgical techniques available. Serious intracranial infection can result in significant surgical morbidity and mortality. This neurosurgical perspective advocates for early minimally invasive surgical intervention to prevent significant surgical morbidity and mortality. https://thejns.org/doi/10.3171/CASE25690.