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[A case of interhemispheric subdural empyema with sinusitis diagnosed by diffusion-weighted MRI]
Hiroyuki Kawano1, Kiminobu Yonemura, Youhei Misumi
1Department of Neurology, Kumamoto City Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|July 19, 2005
Summary
A young man with sinusitis developed a serious brain infection called interhemispheric subdural empyema. Prompt diagnosis with MRI, especially diffusion-weighted imaging (DWI), and surgical drainage led to a full recovery.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Sinusitis can lead to serious intracranial complications.
- Interhemispheric subdural empyema is a rare but potentially life-threatening condition.
Observation:
- A 29-year-old male presented with sinusitis, fever, headache, vomiting, and altered consciousness.
- Initial CT revealed a low-density area; MRI with DWI confirmed interhemispheric subdural empyema.
- The patient experienced initial improvement after sinusitis drainage and antibiotics, but later relapsed with worsening neurological deficits.
Findings:
- Diffusion-weighted imaging (DWI) is crucial for diagnosing interhemispheric subdural empyema.
- Recurrence or expansion of the empyema necessitates further surgical intervention.
- Multimodal imaging, including MRI, is vital for accurate diagnosis and management.
Implications:
- Early and accurate diagnosis of interhemispheric subdural empyema is critical for effective treatment.
- MRI, particularly DWI, enhances diagnostic capabilities for subdural empyema.
- Aggressive surgical management combined with antibiotics can lead to favorable outcomes.