[Subdural empyema complicating sinusitis]

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Updated: Nov 4, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
10:35

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

E Saiag1, D Steir, M Michowitz

  • 1Medical Corps, Israel Defence Forces.

Harefuah
|April 1, 1994
PubMed

Insights

A rare case of subdural empyema (SDE) in a boy with paranasal sinusitis highlights the importance of early diagnosis. Prompt surgical drainage and antibiotics led to a full recovery without lasting neurological issues.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Subdural empyema (SDE) is a rare but serious complication of paranasal sinusitis, accounting for approximately 20% of localized intracranial infections.
  • Early recognition and prompt intervention are crucial for favorable outcomes.

Observation:

  • A 14-year-old boy presented with symptoms including fever, headache, vomiting, and seizures, indicative of complicated sinusitis.
  • Imaging revealed paranasal sinusitis with an air leak and subsequently, an interhemispheric subdural empyema.
  • The patient developed left hemiparesis despite initial antibiotic treatment.

Findings:

  • Surgical intervention via frontal craniotomy successfully drained a large purulent collection.
  • A 4-week course of intravenous antibiotics facilitated complete recovery without neurological sequelae.
  • This case underscores the effectiveness of combined surgical and antibiotic management.

Implications:

  • A high index of suspicion for SDE in patients with sinusitis and neurological symptoms is essential for timely diagnosis.
  • Modern diagnostic tools and aggressive treatment strategies have significantly reduced mortality rates for SDE to 5-10%.
  • Prompt management can prevent long-term neurological deficits associated with intracranial infections originating from paranasal sinuses.

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