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The pediatric headache that would not go away

Bryan Dunn1, Chad McCalla, Brian Hiestand

  • 1From the Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.

Pediatric Emergency Care
|December 5, 2013
PubMed

Insights

Subdural empyema, a serious brain infection, can follow sinusitis. Prompt diagnosis with neuroimaging and treatment including antibiotics and surgery is crucial for favorable outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Subdural empyema is a rare but life-threatening intracranial infection.
  • It often arises as a complication of paranasal sinusitis, otitis media, or mastoiditis.

Observation:

  • A case of subdural empyema in a 14-year-old male with a history of acute sinusitis is presented.
  • Clinical presentation, radiographic findings, and management strategies are detailed.

Findings:

  • Initial evaluation requires comprehensive history, physical exam, laboratory tests (CBC, CRP, ESR), chest X-ray, urinalysis, and contrast-enhanced neuroimaging.
  • Prompt initiation of intravenous antibiotics and neurosurgical consultation for operative drainage are indicated upon identification.

Implications:

  • Early recognition and aggressive management are vital for improving patient outcomes in subdural empyema.
  • This case highlights the importance of considering subdural empyema in patients with sinusitis and neurological symptoms.

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