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Subdural Empyema in the Setting of Multimodal Intracranial Monitoring

Jian Guan1, Emily S Spivak2, Christopher Wilkerson1

  • 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.

World Neurosurgery
|November 10, 2016
PubMed
Abstract

Insights

Multimodal intracranial monitoring for traumatic brain injury can lead to rare complications like subdural empyema. Vigilance for infectious complications is crucial despite the excellent safety profile of advanced monitoring techniques.

Area of Science:

  • Neurosurgery
  • Neurocritical Care
  • Infectious Disease

Background:

  • Multimodal intracranial monitoring is vital for managing traumatic brain injury (TBI).
  • Existing literature extensively covers the benefits of advanced TBI monitoring.
  • Complications associated with multimodal intracranial monitoring are under-discussed.

Observation:

  • A case report details a 32-year-old male with TBI and a Glasgow Coma Scale of 7.
  • The patient underwent multimodal monitoring (brain tissue oxygen and perfusion) and external ventricular drainage.
  • Methicillin-resistant Staphylococcus aureus necessitated antibiotic treatment, preceding the development of subdural empyema.

Findings:

  • The patient developed multifocal subdural empyemas, a rare complication post-monitoring.
  • Surgical evacuation was required for the empyemas.
  • Intraoperative cultures were negative, likely due to prior broad-spectrum antibiotic use.

Implications:

  • This is the first reported case of subdural empyema in the context of multimodal intracranial monitoring for TBI.
  • Neurosurgeons must maintain high vigilance for infectious complications during invasive procedures.
  • Enhanced awareness is needed for potential risks despite the generally safe profile of multimodal monitoring.
Keywords:
ComplicationsInfectionMultimodal intracranial monitoringSubdural empyemaTraumatic brain injury

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