Fulminant subdural empyema treated with a wide decompressive craniectomy and continuous irrigation--case report.

Abstract

A 56-year-old male presented with fulminant subdural empyema manifesting as rhinorrhea, periorbital cellulitis, fever, convulsions, and consciousness disturbance. Neuroimaging showed pansinusitis with skull destruction and extensive subdural empyema. Decompressive craniectomy, irrigation of the empyema, and subdural drainage were performed. Endoscopic sinus surgery was performed to remove the source of infection at the same time. Streptococcus milleri was cultured from the pus. Continuous irrigation of the subdural space with saline containing gentamicin for 7 days resulted in prompt elimination of pus and debris. The patient was discharged with only a slight neurological deficit.

• Authors: Yuji Wada, Takeshi Kubo, Tomoshige Asano, Naoyuki Senda, Mitsuo Isono, Hidenori Kobayashi
• Journal: Neurologia medico-chirurgica (Neurol Med Chir (Tokyo)) Vol. 42 Issue 9 Pg. 414-6 (Sep 2002) ISSN: 0470-8105 [Print] Japan
• PMID: 12371601 (Publication Type: Case Reports, Journal Article)

Topics

• Craniotomy
• Decompression, Surgical
• Empyema, Subdural (diagnosis, surgery)
• Humans
• Image Processing, Computer-Assisted
• Imaging, Three-Dimensional
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Sinusitis (diagnosis, surgery)
• Streptococcal Infections (diagnosis, surgery)
• Therapeutic Irrigation
• Tomography, X-Ray Computed