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Subdural empyemas in children.

J V Pattisapu1, A D Parent

  • 1Pediatric Neurosurgery, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City.

Pediatric Neuroscience
|January 1, 1987
PubMed
Summary
This summary is machine-generated.

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Subdural empyema treatment in children can be successful with prompt surgical intervention and antibiotics. Burr hole drainage is often sufficient, leading to no deaths and good developmental outcomes in this study.

Area of Science:

  • Neurosurgery
  • Pediatric Infectious Diseases

Background:

  • Subdural empyema is a life-threatening neurosurgical emergency.
  • High mortality rates (30-40%) are associated with delayed diagnosis and management.
  • Craniotomy and aggressive medical therapy are traditionally recommended.

Purpose of the Study:

  • To evaluate the efficacy of less invasive surgical techniques for pediatric subdural empyema.
  • To assess outcomes including mortality, morbidity, and neurodevelopmental status.

Main Methods:

  • Retrospective review of 8 children (2 months to 13 years) treated between 1978-1986.
  • Surgical interventions included burr hole and catheter drainage, craniotomy, and subdural taps.
  • All patients received antibiotic therapy.

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Main Results:

  • No deaths occurred in the series.
  • Five children underwent burr hole and catheter drainage; one required craniotomy.
  • Three infants received subdural taps via the anterior fontanel.
  • Five children had no developmental or intellectual deficits at an average 29-month follow-up.

Conclusions:

  • Burr hole and catheter drainage is a sufficient treatment for most pediatric subdural empyemas.
  • Early diagnosis, antibiotics, and timely surgical intervention significantly reduce morbidity and mortality.
  • Less invasive surgical approaches may be effective alternatives to craniotomy.