Cranio-spinal subdural empyema due to S. intermedius: a case report
Angelo Pompucci1, Pasquale De Bonis, Giovanni Sabatino
1Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
Summary
This study presents a rare case of extensive central nervous system (CNS) subdural empyema, affecting both the brain and spine. Prompt diagnosis and surgical intervention led to a full neurological recovery, highlighting the importance of timely management for this challenging condition.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Subdural empyema (SE) is a rare infection between the dura and arachnoid layers.
- While intracranial and spinal SE are known, simultaneous massive central nervous system (CNS) involvement is exceptionally rare and poses management challenges.
Observation:
- A 65-year-old woman presented with extensive intracranial and spinal subdural empyema.
- Diagnosis was established using CT and contrast-enhanced MRI of the cranio-spinal axis.
Findings:
- The patient underwent external ventricular drainage, suboccipital craniectomy, and antibiotic therapy.
- Neurological status progressively improved, with complete recovery and discharge after eight weeks.
Implications:
- This case suggests that spinal and brain subdural empyema can be manifestations of a single, widespread CNS infection.
- Aggressive and prompt diagnosis and treatment are critical for favorable outcomes in complex subdural empyema cases.
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