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Holohemispheric Intracranial Subdural Empyema as a Complication of Orbital Cellulitis

Hadi Abou-El-Hassan1, Yosof Katiby1, Elias A Giraldo2

  • 1Neurology, Arrowhead Regional Medical Center, Colton, USA.

Cureus
|May 27, 2024
PubMed

Insights

Orbital cellulitis can lead to life-threatening intracranial subdural empyema (ISDE). Prompt neurosurgical intervention is crucial for patients presenting with sudden neurological deficits due to ISDE.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Intracranial subdural empyema (ISDE) is a serious infection in the subdural space.
  • Maxillofacial infections, including orbital infections, are common causes of ISDE.
  • ISDE requires prompt medical and surgical management due to its potentially fatal nature.

Observation:

  • A 22-year-old male with sepsis from right orbital cellulitis developed sudden right-sided hemiplegia.
  • Imaging revealed a holohemispheric intracranial subdural empyema.
  • The patient required emergent neurosurgical intervention.

Findings:

  • Orbital cellulitis can serve as a direct pathway for infection to spread to the intracranial subdural space.
  • Intracranial subdural empyema can manifest with acute neurological deficits, such as hemiplegia.
  • Early recognition and surgical drainage are critical for favorable outcomes.

Implications:

  • This case highlights the importance of considering intracranial complications in patients with orbital infections.
  • Prompt neurosurgical evaluation is essential for patients with suspected ISDE and neurological deficits.
  • Effective management of orbital infections may prevent the development of severe intracranial infections like ISDE.
Keywords:
empyemainfectionneurosurgeryorbital cellulitissubdural empyema

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