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[Intracranial subdural empyema. 3 cases].

D Leys, A Destee, G Combelles

    La Semaine Des Hopitaux : Organe Fonde Par L'Association D'Enseignement Medical Des Hopitaux De Paris
    |December 22, 1983
    PubMed
    Summary

    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.

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    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.

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