Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma

Doan, Ninh; Patel, Mohit; Nguyen, Ha Son; Mountoure, Andrew; Shabani, Saman; Gelsomino, Michael; Janich, Karl; Kurpad, Shekar N.

doi:10.1093/jscr/rjw158

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Neurological symptoms such as mental status alteration and seizures, as well as fever and anisocoria were unspecific symptoms of empyema. 2,14 On plain CT imaging, a subdural empyema resembles a subdural hematoma in its crescent shape. In this case, the CT images mimicked a chronic subdural hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…1 The diagnosis and treatment of a subdural empyema are sometimes difficult due to the similar radiological characteristics to chronic subdural hematomas, and the treatment includes the evacuation of the collection associated with intravenous antibiotics. 2 Herein, we present the case of a patient with risk factors who developed a subdural empyema that was treated by surgical and medical means.…”

Section: Introductionmentioning

confidence: 99%

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Subdural Empyema by Enterobacter cloacae: Case Report

Celi

Saal‐Zapata

2020

Indian Journal of Neurotrauma

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Infections of the central nervous system are a medical emergency, potentially lethal and associated with increased morbidity and mortality. We present the case of a male with risk factors and clinical deterioration, in which the brain computed tomography scan showed a subdural collection following a head injury, which underwent surgical evacuation revealing a subdural empyema. The culture of the subdural collection yielded a positive result to Enterobacter cloacae.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Subdural Empyema by Enterobacter cloacae: Case Report

Celi

Saal‐Zapata

2020

Indian Journal of Neurotrauma

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“…Clinical presentation is non-specific, and has many common symptoms with CSDH. Cranial SE is usually a complication of laryngological infections (sinusitis or otitis), but it can stem from mastoiditis, infected cranial procedures, dental complications, meningitis, previous head trauma, and bacteriemic seeding of a previous subdural haematoma [3,10,[13][14]. Conditions or diseases diminishing the patient's resistance to infection may also lead to SE development [13].…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, over 150 years later, despite advanced imaging techniques, diagnosis of this condition can be difficult. It is especially difficult to differentiate intracranial subdural empyaema (ISDE) with chronic subdural haematoma (CSDH), because their presentation in neuroimaging can be similar [2,3]. The case is presented of CSDH mimicking ISDE in a patient with multiple sclerosis (MS) treated with immunosuppressive monoclonal antibody.…”

Section: Introductionmentioning

confidence: 99%

Subdural haematoma mimicking empyema in a patient with multiple sclerosis treated with immunosuppressive monoclonal antibody

Ciesielka¹,

Jamróz-Wiśniewska²,

Bąk³

et al. 2018

J Pre Clin Clin Res.

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Subdural empyema (SE) and subdural haematoma (SH) can present similar radiological signs on magnetic resonance imaging (MRI) of the brain. Natalizumab, a monoclonal antibody used in the treatment of multiple sclerosis (MS), exerts immunosuppressive effects in the CNS and can rarely be complicated by progressive multifocal leukoencephalopathy. In a 39-year-old female treated because of MS with natalizumab, control MRI showed massive thickening of the meninges and multiple fluid reservoirs, described as most probably empyemas and meningitis. The patient denied head trauma. Laboratory tests did not show inflammation. Orthopantomogram showed dental pathologies-a possible source of infection. Despite intense treatment, the MRI lesions remained unchanged. After neurosurgical intervention, chronic SH was diagnosed. A radiological picture of SH and SE could be difficult to differentiate. The aim of the article is to show how unspecific signs in neuroimaging can be caused by chronic SH.

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“…It is defined as an intracranial focal collection of pus in a preformed space between the dura mater and the arachnoid mater [3]. Subdural empyema has been reported in 5-25% of intracranial infections [4]. The presenting symptoms sometimes appear not typical, so the diagnosis of such cases has been a challenge.…”

Section: Introductionmentioning

confidence: 99%

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

et al. 2017

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Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.

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Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma

Cited by 5 publications

References 6 publications

Subdural Empyema by Enterobacter cloacae: Case Report

Subdural Empyema by Enterobacter cloacae: Case Report

Subdural haematoma mimicking empyema in a patient with multiple sclerosis treated with immunosuppressive monoclonal antibody

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

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