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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
Summary
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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