Subdural empyema in infants, children and adults

Farmer, Thomas W.; Wise, Gary

doi:10.1212/wnl.23.3.254

Cited by 92 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Though on occasion, epidural extension of pericranial abscesses through direct erosion of the frontal bone can occur and is presumably the most common etiology when there is a history of trauma or malignancy, often it is the simultaneous involvement of venous structures that leads to the presence of loculated purulent collections both intra- and extracranially [7, 11, 18]. Likewise, although a subdural infection may accompany an epidural counterpart, it is often presumed to result from isolated migration of septic thrombi into venous channels draining into the subdural space [9, 22]. In other cases, retrograde thrombophlebitis may lead to the development of frontal lobe abscesses or even sagittal sinus thrombosis [4].…”

Section: Discussionmentioning

confidence: 99%

Intracranial Complications of Frontal Sinusitis in Children: Pott’s Puffy Tumor Revisited

Bambakidis

Cohen²

2001

Pediatr Neurosurg

155

113

View full text Add to dashboard Cite

The objective of the present study is to describe the diagnosis and treatment of intracranial complications of frontal sinusitis (Pott’s puffy tumor) in a series of pediatric patients at our institution. A rare entity, Pott’s puffy tumor has been reported in only 21 pediatric cases in the literature of the antibiotic era. The hospital records and radiographic files at Rainbow Babies and Childrens Hospital, Cleveland, Ohio, USA, over the previous 16 years were retrospectively reviewed in a search for patients with the diagnosis of Pott’s puffy tumor, defined as scalp swelling and associated intracranial infection. There were 6 male patients and 1 female patient. Ages ranged from 11 to 18 years (median 14.5 years). Intracranial infections consisted of epidural abscess in 5 patients, subdural empyema in 4 and brain abscess in 1. Intraoperative cultures grew anaerobic organisms in 1 patient, microaerophilic streptococcus in 5 patients, Klebsiella species in 1 patient and Streptococcus pneumoniae in another. All patients presented with frontal scalp swelling, and other common symptoms included headache, fever, nasal drainage and frontal sinus tenderness. Five patients were treated with antibiotics prior to their presentation. Four patients presented with neurologic decompensation characterized by varying degrees of hemiparesis, obtundation, pupillary dilatation or aphasia. All patients underwent craniotomy and evacuation of the intracranial infection. Even severely impaired patients demonstrated full neurologic recovery. Despite the widespread use of antibiotics, neurosurgical complications of sinusitis continue to occur. A high degree of suspicion, along with prompt neurosurgical intervention and the use of appropriate antibiotics, can result in favorable outcomes in even the sickest patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Intracranial Complications of Frontal Sinusitis in Children: Pott’s Puffy Tumor Revisited

Bambakidis

Cohen²

2001

Pediatr Neurosurg

155

113

View full text Add to dashboard Cite

show abstract

“…Pneumococcal meningitis is a severe infection of the central nervous system with high morbidity including many neurological sequelae [4,11,12,15,17]. Common complications are hydrocephalus [2,16], intracranial empyema [8], cerebral abscess [1] and involvement of the cranial nerves [6,13], whereas cerebellar lesions are extremely rare [9].…”

Section: Introductionmentioning

confidence: 99%

Cerebellar Involvement as a Rare Complication of Pneumococcal Meningitis

et al. 2000

View full text Add to dashboard Cite

A 4-year old girl with meningitis, caused by streptococcus pneumoniae, developed a subcoma with respiratory insufficiency, followed by a severe cerebellar syndrome. Cerebellar involvement after regaining consciousness consisted of a symmetrical ataxia and mutism. This mutism changed into dysarthria and finally into normal speech. Magnetic resonance imaging revealed lesions in both cerebellar hemispheres, suggesting cerebellitis. She recovered with prompt antibiotic treatment.

show abstract

“…The patient populations being small would not allow objective comparison of the effect of imaging modalities on overall outcome but certainly CT scan is superior to TFUSS used in this study. However, Farmer and Wise[26] lost four of their eight patients in their series and this may be attributable to delayed diagnosis due to lack of CT scan. There is no record of TFUSS being used in any of their patients.…”

Section: Discussionmentioning

confidence: 99%

Infantile subdural empyema: The role of brain sonography and percutaneous subdural tapping in a resource-challenged region

Kanu

Nnoli

Olowoyeye

et al. 2014

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

Background:This study explored the outcome of children with patent anterior fontanelles who were treated with trans-fontanelle ultrasound scan (TFUSS), which is more affordable and available than CT scan and MRI in the diagnosis of childhood intracranial pathologies and treatment of subdural empyema, in developing countries.Patients and Methods:Seventeen infants with post-meningitic subdural empyema, diagnosed using trans-fontanelle ultrasound alone and treated with subdural tapping over a 31-months period, were studied.Results:Eleven patients presented with grades II and III Bannister and William grading for level of consciousness in intracranial subdural empyema. Aspirate from 7 (41.2%) patients were sterile. The most common organisms isolated were Streptococcus faecalis 3 (17.6%), Haemophilus Influenza 2 (11.8) and Staphylococcus aureus 2 (11.8), multiple organisms were isolated in three of the patients. Ninety-four percent (94%) of the patients had good outcome. Five subjects developed hydrocephalus, one patient had a recurrence of subdural empyema, four patients had residual hemiparesis, two of the four patients had speech difficulties, while one patient (~6%) died.Conclusion:While CT and MRI remain the gold standard for investigating intracranial lesions, transfontanelle ultrasonography is adequate for diagnosis of infantile subdural empyema in resource-challenged areas. Percutaneous subdural tap is an affordable and effective therapy in such patients with financial challenges.

show abstract

Subdural empyema in infants, children and adults

Cited by 92 publications

References 0 publications

Intracranial Complications of Frontal Sinusitis in Children: Pott’s Puffy Tumor Revisited

Intracranial Complications of Frontal Sinusitis in Children: Pott’s Puffy Tumor Revisited

Cerebellar Involvement as a Rare Complication of Pneumococcal Meningitis

Infantile subdural empyema: The role of brain sonography and percutaneous subdural tapping in a resource-challenged region

Contact Info

Product

Resources

About