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Subdural empyema presenting with seizure, confusion, and focal weakness

David I Bruner1, Lanny Littlejohn, Amy Pritchard

  • 1Department of Emergency Medicine, Naval Medical Center, Portsmouth, Virginia.

The Western Journal of Emergency Medicine
|January 30, 2013
PubMed

Insights

Intracranial complications of sinusitis, like subdural empyema, are rare but serious. Prompt diagnosis and treatment, including surgical drainage, are crucial for preventing severe outcomes in patients with sinusitis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Sinusitis is common, but intracranial suppurative complications are rare and challenging.
  • Antibiotics have reduced mortality, yet subdural empyemas and abscesses remain significant threats.
  • These complications demand rapid diagnosis, treatment, and often surgical intervention.

Purpose of the Study:

  • To highlight the rare occurrence and diagnostic challenges of intracranial complications secondary to sinusitis.
  • To present a case study of a subdural empyema in an immunocompetent adolescent.
  • To emphasize the importance of timely management in preventing severe neurological sequelae.

Main Methods:

  • Case report presentation.
  • Review of clinical presentation, diagnostic workup, and treatment of a subdural empyema.
  • Discussion of the pathophysiology and management strategies for sinusitis-induced intracranial infections.

Main Results:

  • An immunocompetent adolescent male developed a subdural empyema following sinusitis.
  • The patient presented with seizures, confusion, and focal arm weakness.
  • Successful management involved prompt diagnosis and treatment, likely including surgical drainage.

Conclusions:

  • Subdural empyema is a rare but critical complication of sinusitis.
  • Early recognition and aggressive management are vital to avert mortality and long-term neurological damage.
  • This case underscores the need for vigilance in diagnosing and treating sinusitis complications.

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