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Novel minimally invasive irrigating catheter approach for subdural empyema: a case report
Matthew T Carr1, Roshini Kalagara1, Brandon D Philbrick1
1Department of Neurosurgery, Mount Sinai Hospital, New York, NY, USA.
Objective:
To present a new technique for the management of subdural empyema to promote resolution and prevent recurrence.
Background:
Classic treatment for subdural empyema (SDE) has consisted of antibiotics and surgical treatment with either craniotomy or burrholes. There are still several complications that persist after current treatment, including relatively high rates of morbidity and mortality. In this case report, we present a technique that utilises a novel irrigating-draining catheter to provide a minimally invasive approach for empyema resolution with continuous antibiotic irrigation.
Methods:
In this example case, a 24-year-old male presented to the hospital for new onset headache, lethargy, confusion, and extremity tremors. Initial imaging demonstrated a left frontal extra-axial collection, treated with emergent craniotomy for evacuation of subdural empyema. The subsequent hospital course was complicated by the development of bilateral subdural empyemas which were surgically treated with use of novel irrigating-draining catheters.
Results:
The patient tolerated the procedure well without any complications. He was subsequently discharged to rehab with no deficits or recurrence at a 4-month follow-up visit.
Conclusions:
This minimally invasive novel approach for SDEs can be both safe and effective. Future work should further elucidate the effect of this technique on empyema recurrence and long-term outcomes compared to traditional surgical approaches.
Insights
A novel irrigating-draining catheter offers a safe and effective minimally invasive treatment for subdural empyema (SDE), promoting resolution and preventing recurrence.
Area of Science:
- Neurosurgery
- Infectious Disease Management
- Minimally Invasive Techniques
Background:
- Subdural empyema (SDE) management traditionally involves antibiotics and surgery (craniotomy/burrholes).
- Current treatments have persistent complications, including significant morbidity and mortality rates.
- A novel irrigating-draining catheter approach is presented for SDE management.
Purpose of the Study:
- To introduce a new technique for subdural empyema (SDE) management.
- To promote SDE resolution and prevent recurrence using a novel catheter system.
- To evaluate a minimally invasive approach for SDE treatment.
Main Methods:
- A case report detailing the use of a novel irrigating-draining catheter for SDE.
- The technique involves continuous antibiotic irrigation via the catheter.
- Applied in a patient with bilateral subdural empyemas following initial craniotomy.
Main Results:
- The novel catheter procedure was well-tolerated without complications.
- The patient experienced no deficits or recurrence at 4-month follow-up.
- Successful management of bilateral subdural empyemas was achieved.
Conclusions:
- The novel minimally invasive approach for SDE is safe and effective.
- Further research is needed to compare long-term outcomes with traditional methods.
- This technique shows promise in reducing SDE recurrence.
