Related Experiment Videos
[Intracranial subdural empyema. 3 cases]
Abstract:
With reference to three cases the main features of subdural empyema are recalled. These collected suppurations are often secondary to frontal or maxillary sinusitis due to a streptococcus. Clinical features are those of meningo-encephalitis but signs of cortical damage are more prevalent. Many cases of subdural empyema which would have been unrecognized by conventional procedures are now diagnosed by CT scan. CT scan has also improved monitoring; thus, two of the three patients could be given medical treatment alone. The authors believe that non-surgical treatment would ensure recovery in many cases of subdural empyema. Surgery should be restricted to patients with severe intracranial hypertension or persistence of a large mass after several weeks of antibiotic treatment. Non-surgical treatment may improve prognosis.
Insights
Subdural empyema, often secondary to sinusitis, presents with meningo-encephalitis symptoms. CT scans enable early diagnosis and non-surgical treatment, improving outcomes for many patients.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Subdural empyema is a collection of pus between the dura mater and arachnoid mater.
- Often a complication of frontal or maxillary sinusitis, frequently caused by Streptococcus.
- Clinical presentation can mimic meningo-encephalitis, with a higher prevalence of cortical damage signs.
Observation:
- Computed tomography (CT) scans have significantly improved the diagnosis of subdural empyema, identifying cases previously missed by conventional methods.
- CT imaging also facilitates effective monitoring of treatment progress.
- In two of three presented cases, medical management alone, guided by CT, led to successful outcomes.
Findings:
- Subdural empyema diagnosis is enhanced by CT scans.
- Non-surgical treatment is effective in a significant number of cases.
- Early diagnosis and monitoring via CT are crucial for treatment selection.
Implications:
- Non-surgical management, including antibiotics, can lead to recovery in many subdural empyema cases.
- Surgical intervention should be reserved for severe intracranial hypertension or persistent large masses despite antibiotic therapy.
- Improved diagnostic capabilities with CT scans may lead to better prognoses and reduced surgical necessity in subdural empyema.