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Subdural Empyema.

John E. Greenlee1

  • 1Department of Neurology, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, UT 84132, USA. john.greenlee@hsc.utah.edu

Current Treatment Options in Neurology
|January 11, 2003
PubMed
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Subdural empyema, a dangerous infection of the meninges, requires urgent diagnosis and treatment. Prompt surgical drainage and antibiotics are crucial for survival and preventing severe neurological damage.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Subdural empyema is a loculated infection between the dura and arachnoid layers of the meninges.
  • It can occur intracranially, often secondary to sinusitis, or rarely in the spinal canal due to hematogenous spread or contiguous infection.
  • This condition represents a neurosurgical emergency due to potential rapid compression of the brain or spinal cord.

Purpose of the Study:

  • To review the etiology, diagnosis, and management of subdural empyema.
  • To highlight the critical need for prompt intervention to reduce morbidity and mortality.

Main Methods:

  • Review of literature on subdural empyema.
  • Discussion of diagnostic modalities including MRI and CT myelography.

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  • Outline of recommended antibiotic regimens and surgical approaches.

    • Main Results:

    • Common organisms include Streptococcus milleri group, Staphylococcus aureus, and Gram-negative organisms.
    • MRI with gadolinium enhancement is the preferred diagnostic imaging.
    • Delayed treatment is directly correlated with increased morbidity and mortality.

    Conclusions:

    • Subdural empyema is a medical and neurosurgical emergency requiring immediate treatment.
    • Prompt surgical drainage combined with appropriate antibiotic therapy is essential for favorable outcomes.
    • Early recognition and intervention are key to minimizing neurological deficits and preventing fatalities.