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Related Experiment Videos

Recent diagnostic experience with subdural empyema

M G Luken, M A Whelan

    Journal of Neurosurgery
    |June 1, 1980
    PubMed
    Summary
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    Computerized tomography (CT) scans may miss primary subdural empyemas, even with symptoms. Angiography is crucial for diagnosing these infections when CT is inconclusive.

    Area of Science:

    • Neurology
    • Neurosurgery
    • Radiology

    Background:

    • Subdural empyema diagnosis has evolved with advanced imaging.
    • This study reviews six cases of subdural empyema at the Neurological Institute.

    Observation:

    • Four primary empyema cases presented with fever, altered mental status, and seizures, often with sinus disease.
    • Two secondary empyema cases followed chronic subdural hematoma drainage, showing wound infection.
    • Contrast-enhanced CT scans failed to detect primary empyemas in three cases.
    • Angiography successfully identified primary empyemas and suggested inflammation.
    • CT scans readily visualized secondary empyemas with enhancing membranes.

    Findings:

    • Primary and secondary subdural empyemas present differently and have varying CT diagnostic accuracy.

    Related Experiment Videos

  • Sinus disease suggests primary empyema but its absence doesn't rule it out.
  • CT scans can be unreliable for primary subdural empyema diagnosis in typical clinical presentations.

    • Implications:

    • Angiography is the preferred diagnostic tool for suspected primary subdural empyema when CT is negative.
    • Clinical presentation and imaging findings must be carefully correlated for accurate diagnosis.
    • Understanding differences between primary and secondary empyemas improves patient management.