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[Primary interhemispheric subdural abscess--case report (author's transl)].

S Wada, Y Matsukado, K Kishida

    No Shinkei Geka. Neurological Surgery
    |January 1, 1979
    PubMed
    Summary
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    A rare primary interhemispheric subdural abscess, without other brain involvement, was diagnosed in a boy. Angiography revealed characteristic arterial displacement, confirming the diagnosis and guiding successful surgical treatment.

    Area of Science:

    • Neurology
    • Neurosurgery
    • Radiology

    Background:

    • Primary interhemispheric subdural abscesses are uncommon, often presenting with non-specific symptoms.
    • Early and accurate diagnosis is crucial for effective management and patient outcomes.

    Observation:

    • A 13-year-old boy presented with fever, headache, and left lower extremity weakness, progressing to seizures.
    • Cerebral angiography demonstrated characteristic separation of anterior cerebral artery branches, indicating an interhemispheric subdural collection.
    • Cerebrospinal fluid analysis showed no signs of purulent infection, and EEG revealed diffuse slow wave activity.

    Findings:

    • Surgical confirmation of a primary interhemispheric subdural abscess.
    • Initial treatment with antibiotics and steroids showed partial improvement, but serial angiography revealed worsening mass effect.

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  • Complete resolution of the abscess and neurological recovery were achieved post-operatively.

    • Implications:

    • Highlights the diagnostic utility of angiography in identifying interhemispheric subdural abscesses.
    • Emphasizes the importance of considering rare diagnoses in the presence of atypical neurological presentations.
    • Demonstrates the successful management of a primary interhemispheric subdural abscess through surgical intervention.