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Spontaneous tension pneumocephalus in a patient with subdural empyema

Rakesh Redhu1, Abhidha Shah, Madan Jadhav

  • 1Department of Neurosurgery, King Edward VII Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Dr. E Borges Marg, Parel, Mumbai 400012, India.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|June 18, 2011
PubMed

Insights

A rare case of subdural empyema caused by gas-forming Escherichia coli led to tension pneumocephalus. This unusual bacterial infection resulted in fatal neurological complications despite treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Subdural empyema (SE) is a serious intracranial infection.
  • Tension pneumocephalus is a rare but life-threatening complication of SE.

Observation:

  • A 45-year-old male presented with unconsciousness and extensor posturing.
  • Escherichia coli, a gas-forming bacterium, was identified as the causative agent of SE.
  • A large air loculus within the SE cavity was noted, linked to bacterial gas production.

Findings:

  • The patient developed tension pneumocephalus secondary to gas produced by E. coli within the subdural empyema.
  • Despite surgical intervention and antibiotics, the patient's condition deteriorated, leading to death.

Implications:

  • This case highlights a novel mechanism of tension pneumocephalus in subdural empyema.
  • The presence of gas-forming organisms in SE requires careful consideration for potential pneumocephalus development.
  • This report underscores the critical need for prompt diagnosis and management of SE, especially when complicated by gas-producing pathogens.

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