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Subdural empyema in children
Dattatraya Muzumdar1, Naresh Biyani2, Chandrashekhar Deopujari2
1Department of Neurosurgery, King Edward VII Memorial hospital, Parel, Mumbai, 400012, India. dmuzumdar@hotmail.com.
Insights
Subdural empyema, a pus collection in the brain's subdural space, requires prompt recognition and treatment. Surgical intervention and antibiotics are crucial for favorable outcomes in this pediatric neurosurgical emergency.
Area of Science:
- Pediatric Neurosurgery
- Infectious Diseases
- Neurology
Background:
- Subdural empyema involves pus in the subdural space, often affecting infants and children.
- Common causes include bacterial meningitis in infants and sinusitis or otitis media in older children.
- Symptoms range from fever and seizures to signs of meningitis and increased intracranial pressure.
Purpose of the Study:
- To review the clinical profile, causes, imaging, and management of subdural empyema in children.
- To synthesize current literature on pediatric subdural empyema.
Main Methods:
- Literature review of relevant studies on pediatric subdural empyema.
- Discussion of clinical presentation, etiopathogenesis, imaging findings, and treatment strategies.
Main Results:
- Subdural empyema is a critical neurosurgical condition demanding urgent diagnosis.
- Clinical presentation is diverse, often mimicking or complicating meningitis.
- Imaging is key for diagnosis and guiding management.
Conclusions:
- Prompt recognition and surgical decompression (burr hole or craniotomy) are vital.
- Complete pus evacuation and prolonged intravenous antibiotics are essential for successful treatment.
- Effective management of subdural empyema in children prevents severe complications.
Background:
Subdural empyema denotes the collection of purulent material in the subdural spaceand is commonly seen in infants and older children. In infants, the most common cause is bacterialmeningitis. In older children, sinusitis and otitis media are usually the source for subdural empyema. Theclinical symptomatology is varied and has a wide range including prolonged or recurrent fever, seizures,meningeal irritation, and raised intracranial pressure. It can mimic as well as complicate meningitis and aheightened clinical awareness is therefore paramount.
Aims And Objectives:
The clinical profile, etiopathogenesis, imaging features and management of subdural empyema in children is discussed and the relevant literature is reviewed.
Conclusion:
Subdural empyema is a neurosurgical emergency and rapid recognition and treatment canavoid life-threatening complications. In most cases, surgical decompression through burr hole or craniotomyis warranted. Near complete evacuation of the purulent material and appropriate long-term intravenous antibiotics are necessary for a gratifying outcome.
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