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Intracranial tuberculous subdural empyema: case report

A van Dellen1, S S Nadvi, N Nathoo

  • 1Department of Neurosurgery, University of Natal Medical School and Wentworth Hospital, Durban, South Africa.

Neurosurgery
|August 8, 1998
PubMed
Summary

This case report details an intracranial tuberculous subdural empyema, a rare form of neurotuberculosis. Prompt surgical drainage and prolonged anti-tuberculosis therapy led to a good recovery.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Neurotuberculosis (TB) encompasses various intracranial manifestations, primarily tuberculous meningitis and tuberculomas.
  • A rare case of intracranial tuberculous subdural empyema is presented, highlighting an unusual presentation of neurotuberculosis.

Observation:

  • A 59-year-old male with a history of pulmonary TB presented with chronic headaches.
  • Cranial CT revealed a subdural collection with mass effect, osteitis, and scalp swelling.

Findings:

  • Surgical drainage yielded tuberculous granulation tissue with acid-fast bacilli; Mycobacterium TB was cultured.
  • The patient underwent craniectomy, pus drainage, and required further procedures and prolonged anti-TB treatment.

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Implications:

  • Surgical intervention is crucial for relieving mass effect and obtaining microbiological diagnosis in tuberculous subdural empyema.
  • An 18-month course of anti-TB chemotherapy combined with close compliance monitoring is recommended for optimal outcomes.