Subdural empyema


Bacterial or fungal infections of the sinuses can spread to the subdural space and produce a subdural empyema.

It is a form of empyema in the subdural space.

The underlying arachnoid and subarachnoid spaces are usually unaffected.

A thrombophlebitis may develop in the bridging veins that cross the subdural space, resulting in venous occlusion and infarction of the brain.

Symptoms include those referable to the source of the infection.

Most patients are febrile, with headache and neck stiffness, and may develop focal neurologic signs, lethargy, and coma.

The CSF profile is similar to that seen in brain abscess.

It usually occurs in infancy, and can be associated with sinusitis.

May produce a mass effect if large.

Most patients have fever, headache, neck stiffness, focal neurologic changes, lethargy and coma may result.

Because of the location of the infection next to the meninges the CSF may be under increased pressure, with increased white blood cells and increased protein level and normal survival content.

Treatment includes surgical drainage.

Early diagnosis and treatment result in complete recovery.

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