Related Experiment Video

Updated: Jul 13, 2026

Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
04:04

Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection

Published on: August 15, 2025

The clinical challenge of recognizing infratentorial empyema

Diederik van de Beek1, Norbert G Campeau, Eelco F M Wijdicks

  • 1Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

Neurology
|August 1, 2007
PubMed
Abstract

Insights

Infratentorial empyema, a rare complication of bacterial meningitis, requires prompt diagnosis and neurosurgical intervention. Early MRI is crucial for identifying posterior fossa lesions and improving patient outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Infratentorial empyema is a rare but serious complication of bacterial meningitis.
  • Knowledge regarding its recognition and management remains limited.

Observation:

  • Patients often present with subacute meningitis, neck stiffness, and decreased consciousness.
  • Diagnosis can be delayed, with cerebellar signs and cranial nerve deficits being infrequent.
  • Associated otitis, sinusitis, or mastoiditis, and recent surgery for these conditions are diagnostic clues.

Findings:

  • Craniotomy is frequently performed, while antibiotic-only treatment risks relapse.
  • Mortality rates are high, particularly in cases of subdural empyema.
  • CT scans may fail to adequately visualize infratentorial subdural empyema.

Implications:

  • Infratentorial empyema is a life-threatening condition necessitating urgent management.
  • MRI, especially diffusion-weighted imaging, is the preferred diagnostic modality.
  • Neurosurgery is the recommended first-line therapy for optimal outcomes.

Related Concept Videos

Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations: