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The treatment and outcome of postmeningitic subdural empyema in infants

Zhuo-Hao Liu1, Nan-Yu Chen, Po-Hsun Tu

  • 1Department of Neurosurgery, Chang Gung Memorial College of Medicine, Hospital and Chang Gung University, Linkou, Taiwan.

Journal of Neurosurgery. Pediatrics
|July 3, 2010
PubMed

Insights

Subdural empyema (SDE) in infants following meningitis can be effectively managed with either craniotomy or bur hole drainage. Both methods yield similar favorable outcomes, with bur hole drainage being less invasive.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases

Background:

  • Subdural empyema (SDE) management, particularly following meningitis in infants, lacks comparative data between craniotomy and bur hole drainage.
  • Both craniotomy and bur hole drainage have demonstrated favorable outcomes in SDE management.

Purpose of the Study:

  • To compare the outcomes of craniotomy versus bur hole drainage for infants with SDE secondary to meningitis.
  • To analyze clinical presentation, diagnostic data, and postoperative results in two surgical groups.

Main Methods:

  • Retrospective review of 33 infants with SDE due to meningitis (2000-2006).
  • Comparison of preoperative clinical data, symptom duration, radiological findings, CSF analysis, and postoperative outcomes between craniotomy and bur hole drainage groups.

Main Results:

  • No significant differences were observed in patient demographics, clinical presentation, or CSF analysis at diagnosis.
  • Outcomes including time to becoming afebrile, antibiotic duration, neurological status, recurrence, and complications were similar between the surgical groups.
  • A single mortality occurred in the series.

Conclusions:

  • Infant SDE post-meningitis presents unique pathophysiological and clinical characteristics.
  • Early detection and surgical intervention for SDE lead to favorable outcomes regardless of surgical approach.
  • Bur hole drainage offers a less invasive option with comparable clinical outcomes to craniotomy for post-meningitic SDE.
Abstract

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