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Subdural Empyema as a Sequela of Severe Erosive Sinusitis: A Case Report

Ahmed Madan1, Madison Wilson2,3, Andy Garcia4

  • 1General Surgery, Larkin Community Hospital, South Miami, USA.

Cureus
|September 24, 2024
PubMed

Insights

Intracranial subdural empyema, a serious brain infection, requires urgent surgical drainage and antibiotics. Prompt treatment of this rare condition significantly improves patient outcomes and prevents neurological damage.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Radiology

Background:

  • Intracranial subdural empyema is a rare but life-threatening neurosurgical emergency.
  • It involves pus accumulation between the brain's dura mater, often stemming from infections like sinusitis or otitis media, or head trauma.

Observation:

  • A 45-year-old male presented with progressive lethargy and altered mental status, initially suspected of having a subdural hematoma.
  • Advanced imaging confirmed intracranial subdural empyema, necessitating emergent surgical intervention.

Findings:

  • The patient underwent a right-sided craniotomy for subdural drainage.
  • Post-operatively, he received a combination of linezolid, cefepime, and metronidazole, leading to significant clinical improvement.

Implications:

  • This case underscores the critical importance of prompt diagnosis and multi-modal treatment, including surgical decompression and targeted antimicrobial therapy, for intracranial subdural empyema.
  • Effective management of this rare condition can lead to favorable neurological recovery and prevent severe complications.
Keywords:
craniotomyfunctional endoscopic sinus surgeryinfectioussinusitissubdural empyema

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