[Subdural abscess in infant and child (author's transl]

Area of Science:

• Pediatric Neurosurgery
• Infectious Diseases in Children
• Neuroradiology

Background:

• Subdural abscesses are rare but serious infections in infants and children.
• Prompt diagnosis and effective treatment are crucial for preventing neurological sequelae.
• Septicemia, particularly from Gram-negative bacteria like E. coli, can be a precursor.

Observation:

• Case 1: A 1.4-year-old boy with a history of head trauma presented with symptoms of infection and was diagnosed with bilateral subdural abscesses and effusion.
• Case 2: A 3-month-old infant presented with fever, neck stiffness, and seizures, diagnosed with subdural effusion and abscess.
• CT scans revealed characteristic low-density areas, evolving to high-density rims with contrast enhancement, indicative of abscess formation and chronic effusion.

Findings:

• Both cases demonstrated successful treatment of subdural abscesses using irrigation via burr holes.
• The study highlights the importance of differentiating between subdural abscesses and subdural effusions on imaging.
• E. coli septicemia was identified as a potential etiology in one case.

Implications:

• Irrigation via burr holes is a viable and effective surgical approach for pediatric subdural abscesses.
• Early recognition of CT findings suggestive of subdural collections is vital for timely intervention.
• Understanding the infectious etiology and routes of spread aids in comprehensive patient management.