Résumé
The authors describe two cases of interhemispheric subdural empyema. Both presented with fever, headache and seizures. Imaging revealed interhemispheric subdural empyema. Aspiration of empyema through a burr hole was done in both cases with good postoperative recovery
Sujets)
Humains , Mâle , Empyème subdural/imagerie diagnostique , Tomodensitométrie , Imagerie par résonance magnétique , Facteurs âges , MortalitéRésumé
Malaria is one of the most common diseases in tropical countries. In our country, malaria is endemic in some parts of south and east. Cerebral malaria is usually a diffuse symmetric encephalopathy with focal signs being unusual. We present a two-year old girl with fever and seizure while undergoing treatment for malaria. Imaging disclosed acute subdural empyema. Investigations revealed anemia, thrombocytopenia and positive peripheral blood smear for vivax malaria. Treatment involved surgical evacuation of the subdural empyema, oral chloroquin and antibiotics. This is the third case report of spontaneous subdural empyema in complicated malaria and highlights a rare but surgically manageable complication
Sujets)
Humains , Femelle , Paludisme cérébral/diagnostic , Paludisme cérébral/anatomopathologie , Paludisme/complications , Paludisme cérébral/thérapie , Empyème subdural/imagerie diagnostique , Empyème subdural/chirurgie , Plasmodium vivaxRésumé
CLINICAL HISTORY: Malaria is one of the most common diseases in the tropical countries. Cerebral malaria is usually a diffuse symmetric encephalopathy with focal signs being unusual. METHODS : We present a three-year old girl lapsing into unconsciousness following a seizure while undergoing treatment for malaria. Imaging revealed a large heterogenous density, left hemispheric acute subdural haematoma with brain herniation. Investigations revealed anaemia, thrombocytopenia and positive peripheral blood smear for falciparum malaria. RESULTS: Treatment involved surgical evacuation of the clot and the associated subdural empyema, intravenous quinine and antibiotics. CONCLUSION: This is the second case report of spontaneous subdural empyema in complicated falciparum malaria and highlights a rare but surgically manageable complication.
Sujets)
Enfant d'âge préscolaire , Empyème subdural/imagerie diagnostique , Issue fatale , Femelle , Humains , Paludisme à Plasmodium falciparum/complications , Complications postopératoiresRésumé
A rare case of otogenic massive intra-falx empyema is reported. The patient presented with headache, vomiting and left lower limb weakness of 8 months duration. C.T. scan revealed two cavities in the falx. Right fronto-parietal craniectomy and drainage of massive empyema was undertaken through interhemispheric approach with wide opening of the falx, evacuation of voluminous amount of thick pus and marsupalization of flax with dura. The patient showed complete recovery. The relevant literature is briefly reviewed.
Sujets)
Enfant , Craniotomie , Dure-mère/imagerie diagnostique , Empyème subdural/imagerie diagnostique , Humains , Mâle , TomodensitométrieRésumé
A 16 year old male was admitted with a clinical picture suggesting an intracranial pyogenic infection. He also has focal convulsions and left abducens palsy. CT scan showed a subdural empyema with interhemispheric extension. Since the patient was improving clinically, neurosurgical intervention was deferred. Spontaneous interhemispheric empyema is an uncommon condition. In our case conservative management was curative in what is considered a neurosurgical emergency.