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[Subdural abscess following chronic subdural hematoma]

A Hirano1, T Takamura, N Murayama

  • 1Department of Neurosurgery, Hakodate City Hospital.

No Shinkei Geka. Neurological Surgery
|July 1, 1995
PubMed
Summary

A subdural abscess developed in an elderly male with chronic subdural hematoma, likely due to Escherichia coli bacteremia from chronic cholecystitis and weakened immunity.

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Geriatrics

Background:

  • Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly.
  • Subdural abscesses are rare but serious complications that can arise from various sources.
  • The interplay between CSDH, infection, and host factors in the elderly remains an area of interest.

Observation:

  • An 86-year-old male presented with drowsiness and left hemiparesis.
  • CT revealed right CSDH and suspected left subdural collection.
  • Fever persisted for two years, linked to chronic cholecystitis and cholelithiasis.

Findings:

  • Emergency right CSDH evacuation revealed a subdural abscess.
  • Escherichia coli was identified in the abscess culture.

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  • Postoperative MRI confirmed the right subdural abscess and left CSDH.
  • Left CSDH evacuation did not reveal an abscess.

    • Implications:

    • Bacteremia from chronic cholecystitis may lead to subdural abscess formation.
    • Impaired immunity in the elderly could facilitate abscess development.
    • This case highlights the importance of considering infection in CSDH patients with systemic illness.