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Subdural empyema and cerebellar abscess due to chronic otitis media

K S Polyzoidis1, G Vranos, G Exarchakos

  • 1Department of Neurosurgery, University of Ioannina, Medical School, Ioannina, Greece.

International Journal of Clinical Practice
|April 2, 2004
PubMed

Insights

Infratentorial subdural empyema, a rare complication of chronic otitis media, can be fatal. Early surgical intervention and antibiotics offer a life-saving treatment for this severe intracranial infection.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Infratentorial subdural empyema, often with cerebellar abscess, is a rare but highly fatal condition.
  • Chronic otitis media can lead to severe intracranial complications, including subdural empyema.

Observation:

  • A 49-year-old male with a history of neglected chronic otitis media presented with severe debility and fever.
  • Radiological imaging revealed infratentorial subdural suppuration extending into the cerebellum and chronic infection of the middle ear and mastoid.
  • The patient's neurological status deteriorated, necessitating urgent surgical intervention.

Findings:

  • Surgical management included radical mastoidectomy followed by posterior fossa craniectomy.
  • Successful evacuation of subdural collections and cerebellar abscess was achieved.
  • Post-operative antibiotic treatment for six weeks resulted in complete neurological recovery with minor residual cerebellar dysfunction.

Implications:

  • This case underscores the critical importance of early diagnosis and aggressive surgical management for intracranial complications of chronic otitis media.
  • Prompt intervention can be life-saving and lead to significant neurological recovery.
  • Highlights the need for timely surgical treatment in patients with advanced otitis media and neurological decline.

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