ABSTRACT
RESUMEN: Los empiemas subdurales, tanto los de aparición espontánea o como complicación en la evolución de un hematoma subdural (HSD), son infrecuentes y de los cuales existen pocas publicaciones en la literatura(1). En este trabajo se revisa una serie de 15 casos operados en el Hospital de Urgencia Asistencia Pública (HUAP) en un período de 15 años. Se observó que en general tienen buena evolución con el tratamiento instaurado en forma oportuna y que son larvados en su presentación, pudiendo llegar a ser diagnosticados incluso en el intraoperatorio. No se observó diferencia en su evolución cuando se operaron a través de una craniectomía o de una craneotomía (plaqueta)(2). No se encontró tampoco diferencia cuando se trataron con o sin drenaje. Como consenso general, deben ser tratados con antibioticoterapia prolongada de al menos 3-4 semanas para controlar el foco infeccioso(2). Ninguno de los casos revisados requirió de reintervención.
ABSTRACT Subdural empyemas, both spontaneous or as a complication in the evolution of subdural hematomas, are an uncommon fact of which there are few publications in literature. In this review we analyze a retrospective serie of 15 cases operated in HUAP in a period of 15 years. In general we don't observed differences in the outcome using different surgical techniques, both in those treated by craniectomy as those treated by craniotomy. Also we don't observed differences in those treated with or without drainage. In the same way is clear that the optimal period of antibiotic treatment must be 3-4 weeks to fully cover them. None of the cases treated, needed reintervention.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Empyema, Subdural/complications , Empyema, Subdural/epidemiology , Hematoma, Subdural/etiology , Empyema, Subdural/therapy , Retrospective Studies , Craniotomy , Age and Sex Distribution , Anti-Bacterial Agents/therapeutic useABSTRACT
A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE) recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months) that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.
Subject(s)
Humans , Male , Middle Aged , Brain Abscess/microbiology , Brain Abscess/therapy , Brucellosis/complications , Brucellosis/therapy , Empyema, Subdural/microbiology , Empyema, Subdural/therapy , Anti-Bacterial Agents/therapeutic use , Brain Abscess/pathology , Brain Hemorrhage, Traumatic/complications , Craniotomy/methods , Drainage/methods , Hematoma, Subdural/complications , Magnetic Resonance Imaging , Treatment OutcomeABSTRACT
Intracranial abscess and empyemas from ENT infection are rare. The aim of our study was to recall the treatment and therapeutic results. It was a retrospective study from 1995 to 2006 concerning. 23 patients who had brain abscesses secondary to an ENT infection. The infections origin was otological in 56% of cases, sinusal in 44%. Bacterias were identified in 40% of cases. All patients benefited a medical treatment to basis of at least 2 antibiotics a long length going from 20 days to 3 less by intravenous way. Nine patients benefited neurosurgery with an ENT treatment surgical. Nine patients had alone neurosurgery and 5 cases had an ENT surgery alone. The treatment consists in excision or single punction of the abscess. 72% are alive and well. We have no dead. The classical intracranial hypertension associated to high fever is usually truncated. The diagnosis is more precocious thanks to the progress of the medical imagery. Multibacterial infections are frequent. Treatment is medical and surgical. Recovery requires a specific surgical treatment of the ENT infection in more than 60% of cases. An adapted treatment permits a recovery without after effects in at least the half of cases
Subject(s)
Humans , Male , Female , Empyema, Subdural/diagnosis , Empyema, Subdural/therapy , Brain Abscess/diagnosis , Empyema/diagnosis , Retrospective Studies , Otorhinolaryngologic Diseases/complications , Tomography, X-Ray Computed , Magnetic Resonance ImagingABSTRACT
El empiema subdural es una complicación infrecuente de la sinusitis en niños. Esta condición se acompaña de una alta morbi mortalidad, por lo que es considerada una emergencia neuro-quirúrgica. Se describe la evolución clínico imagenológica de un escolar previamente sano que cursa con un empiema subdural secundario a una pansinusitis y se discute la presentación clínica, diagnóstico imagenológico y tratamiento médico-quirúrgico de esta patología en base a una revisión de la literatura.
Subject(s)
Male , Humans , Child , Empyema, Subdural/diagnosis , Empyema, Subdural/etiology , Empyema, Subdural/therapy , Sinusitis/complications , Brain Abscess/etiology , Brain Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Anticonvulsants/therapeutic use , Craniotomy , Cerebrum , Drainage , Paranasal Sinuses , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Subdural empyema [SDE] is a significant cause of neurological morbidity and mortality. It should be recognized early and treated as an emergency. Although convexity subdural empyema is not so uncommon but parafalcine subdural empyema is quite rare. A recent case of parafalcine subdural empyema managed at Prince Abdullah Bin Abdulaziz Hospital, Bisha [KSA] is discussed. The epidemiology, pathophysiology, bacteriology, clinical features, radiographic findings and treatment of this life-threatening entity are reviewed
Subject(s)
Humans , Male , Empyema, Subdural/therapy , Brain/pathology , Empyema, Subdural/physiopathology , Tomography, X-Ray ComputedABSTRACT
Se analizan las historias clínicas de 11 niños con diagnóstico de empiema subdural. Las edades oscilaban entre 23 días y 11 años, 6 eran mujeres y 5 varones. La etiología postmeningitica fue la más frecuente (6 casos) era desconocida en 3 niños. Secundaria a colesteatoma de oído medio y a hematoma a subdural infectado en 2 casos. Las manifestaciones clínicas predominantes fueron: la hipertensión endocraneana, crisis convulsiva y sindrome toxi-infeccioso. En 54 por ciento de los niños existía hemiparesia de grado variable. Se resalta el valor de la TAC en el diagnóstico de la afección. El 91 por ciento de los pacientes se intervino, utilizando diversos procedimientos (craneotomía, evacuación por orificio de trépano y/o punción transfontanelar). En un caso se realizó tratamiento médico-conservador. La mortalidad de la serie fue del 1 por ciento