[Trial of initial non surgical treatment of subdural empyema]

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Neurosurgery

Background:

• Sinusitis can lead to serious intracranial complications.
• Brain empyema is a rare but critical neurosurgical emergency.

Observation:

• An 8-year-old girl presented with bilateral subdural frontoparietal and interhemispheric empyema secondary to sinusitis.
• Initial treatment involved a 3-week course of parenteral antibiotics, leading to temporary improvement.

Findings:

• Clinical deterioration necessitated surgical drainage.
• Post-surgical evaluation revealed bilateral frontoparietal brain edema and sterile abscess fluid.
• The evolution of the condition was linked to brain edema rather than persistent infection.

Implications:

• Prompt diagnosis and multimodal treatment (antibiotics and surgical drainage) are crucial for managing pediatric brain empyema.
• Brain edema can complicate the clinical course even with sterile abscesses.
• This case highlights the importance of vigilant monitoring and aggressive management in pediatric intracranial infections.