Subdural empyema (SDE) is an infection between the dura and arachnoid mater, presenting with symptoms such as fever, headache, altered sensorium, neurological deficits, and seizures. Due to its rapidly progressive nature, early diagnosis and treatment are crucial. This paper aims to identify common pathogens, imaging findings, and the necessity of emergent neurosurgical intervention. We present the case of a 49-year-old woman with an SDE who underwent craniotomy to evacuate pus and hematoma. Cultures confirmed and the patient improved postoperatively with the complete evacuation of the SDE and resolution of midline shift seen on the CT scan. A PubMed literature review focused on consolidating data to identify common pathogens, demographic details, treatment methods and duration, and outcomes in SDE. SDE requires prompt diagnosis and treatment. Contrast-enhanced brain MRI is crucial for diagnosis, showing features distinct from subdural hematoma or hygroma. Neurosurgical intervention is urgent, including craniotomy and evacuation. Postoperative broad-spectrum antibiotic therapy is essential until specific pathogens are identified, and a multidisciplinary approach is recommended.
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http://dx.doi.org/10.7759/cureus.76800 | DOI Listing |
Eur J Case Rep Intern Med
February 2025
Department of General Practice, The Medical Centre, Roscommon, Ireland.
Unlabelled: Pott's puffy tumor, a rare complication of frontal sinusitis or trauma, presents with subperiosteal abscess and osteomyelitis of the frontal bone. Early diagnosis with imaging studies and prompt treatment with antibiotics and percutaneous drainage of the abscess requires in most cases for a successful outcome. We report a case of a 12-year-old boy who initially presented with left sided retro-orbital/frontal area headache associated with high grade temperature and painful localized small forehead swelling.
View Article and Find Full Text PDFObjective: Early recognition of Bacterial sinusitis as a rare presentation of cerebral venous sinus thrombosis (CVST) in pediatric patients with intractable headaches.
Background: CVT is caused by thrombotic obstruction of the venous sinuses leading to increased ICP with neurological deficits. It can present as a complication of rhinosinusitis, streptococcus anginosus () being the most notorious in pediatric age groups.
Cureus
January 2025
Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Subdural empyema (SDE) is an infection between the dura and arachnoid mater, presenting with symptoms such as fever, headache, altered sensorium, neurological deficits, and seizures. Due to its rapidly progressive nature, early diagnosis and treatment are crucial. This paper aims to identify common pathogens, imaging findings, and the necessity of emergent neurosurgical intervention.
View Article and Find Full Text PDFNeurochirurgie
January 2025
Pediatric Neurosurgery Department, CHRU Nancy, France. Electronic address:
Objectives: This study aims to analyze a series of cases admitted with intracranial empyema, either subdural or epidural, secondary to otorhinolaryngological (ENT) infections over a period of 10 years, including the COVID-19 pandemic. The incidence, characteristics, severity, and management of these conditions, as well as the influence of COVID-19, are described below.
Methods: The authors conducted a retrospective review of all of the children admitted to the Pediatric Neurosurgery Department of Nancy with intracranial empyemas secondary to a confirmed sinus (sinogenic) or mastoid (otogenic) infection between 2014 and 2024.
Diagn Microbiol Infect Dis
March 2025
Department of Neuro-endovascular Surgery, Apollo Hospital, Chennai, 600006, India.
We report the successful management of two cases of brain abscess and subdural empyema caused by Fusobacterium nucleatum and Streptococcus intermedius diagnosed using 16S ribosomal RNA (rRNA) sequencing where microbiological culture showed no growth. This report elucidates the utility of next-generation sequencing (NGS) in determining the microbial etiology and guiding appropriate antimicrobial treatment in life-threatening neurological infections.
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