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Pediatric parafalcine empyemas

Franziska Niklewski1, Athanasios K Petridis2, Jasmin Al Hourani2

  • 1Department of Neurosurgery, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany Department of Pediatrics, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany franzi.niklewski@googlemail.com.

Journal of Surgical Case Reports
|June 26, 2014
PubMed

Insights

Pediatric parafalcine abscesses, a rare complication of bacterial sinusitis, often require repeat surgical intervention. Close imaging follow-up is crucial for effective management of these complex brain infections.

Area of Science:

  • Neurology
  • Pediatric Infectious Diseases
  • Neurosurgery

Background:

  • Bacterial sinusitis can lead to rare but serious complications like subdural intracranial empyemas and brain abscesses.
  • Pediatric parafalcine abscesses present unique management challenges compared to other brain abscess locations.

Observation:

  • Two pediatric cases of parafalcine abscesses secondary to sinusitis are presented.
  • Both cases experienced recurrent empyema after initial surgical treatment and antibiotics, necessitating a second surgical evacuation.

Findings:

  • Surgical evacuation of pus is the primary treatment for parafalcine abscesses, especially when remnants are visualized.
  • A 3-month antibiotic course was administered in both cases.
  • Short-term follow-up imaging is essential, regardless of clinical or blood infection markers.

Implications:

  • Recurrence is possible, highlighting the need for vigilant monitoring post-treatment.
  • Parafalcine abscesses may benefit from a 'second look' surgical approach.
  • Effective management requires a combination of surgical intervention and prolonged antibiotic therapy.

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