Subdural Empyema in Children

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2018 Jul 18

PMID 30014307

Citations 13

Authors

Dattatraya Muzumdar

Naresh Biyani

Chandrashekhar Deopujari

Affiliations

Soon will be listed here.

Abstract

Background: Subdural empyema denotes the collection of purulent material in the subdural spaceand is commonly seen in infants and older children. In infants, the most common cause is bacterialmeningitis. In older children, sinusitis and otitis media are usually the source for subdural empyema. Theclinical symptomatology is varied and has a wide range including prolonged or recurrent fever, seizures,meningeal irritation, and raised intracranial pressure. It can mimic as well as complicate meningitis and aheightened clinical awareness is therefore paramount.

Aims And Objectives: The clinical profile, etiopathogenesis, imaging features and management of subdural empyema in children is discussed and the relevant literature is reviewed.

Conclusion: Subdural empyema is a neurosurgical emergency and rapid recognition and treatment canavoid life-threatening complications. In most cases, surgical decompression through burr hole or craniotomyis warranted. Near complete evacuation of the purulent material and appropriate long-term intravenous antibiotics are necessary for a gratifying outcome.

Citing Articles

Microbial Analyses of Subdural Empyema: A Case Report and Literature Review.

Arbuckle B, Kasem R, Shaik A, Downes A, Hwang S, Passias P Cureus. 2025; 17(1):e76800.

PMID: 39897219 PMC: 11786810. DOI: 10.7759/cureus.76800.

Intracranial Subdural Empyema During Long-term Chemotherapy for Metastatic Colorectal Cancer: Case Report.

Shimogawa T, Miyamoto Y, Hiyoshi Y, Ouchi M, Kosumi K, Eto K In Vivo. 2024; 38(5):2557-2561.

PMID: 39187332 PMC: 11363758. DOI: 10.21873/invivo.13730.

Clinical Management and Neurosurgical Approach of Pott's Puffy Tumor: A Case Report.

Furtado L, Gil Nunes L, Fernandes C, Guimaraes Pinto P, Filho J Cureus. 2024; 16(7):e63686.

PMID: 38957509 PMC: 11218928. DOI: 10.7759/cureus.63686.

The Epidemiology, Management and Therapeutic Outcomes of Subdural Empyema in Neonates with Acute Bacterial Meningitis.

Lee W, Tsai M, Hsu J, Chu S, Chen C, Yang P Antibiotics (Basel). 2024; 13(4).

PMID: 38667053 PMC: 11047628. DOI: 10.3390/antibiotics13040377.

Imaging findings of posterior fossa subdural empyema secondary to neonatal bacterial meningitis.

Luo H, Li H, Hu D, Yang S, Peng Y Quant Imaging Med Surg. 2024; 14(3):2721-2724.

PMID: 38545045 PMC: 10963804. DOI: 10.21037/qims-23-1113.

References

Salunke P, Malik V, Kovai P, Mukherjee K . Falcotentorial subdural empyema: analysis of 10 cases. Acta Neurochir (Wien). 2010; 153(1):164-9. DOI: 10.1007/s00701-010-0695-5. View

Prober C, Bachrach L, Humphreys R, Hendrick B, Mehren K, Rapley W . An unusual case of intracranial suppuration. Pediatr Infect Dis. 1985; 4(1):101-3. DOI: 10.1097/00006454-198501000-00026. View

De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A . Cranial and spinal subdural empyema. Br J Neurosurg. 2009; 23(3):335-40. DOI: 10.1080/02688690902939902. View

Aldinger F, Shiban E, Gempt J, Meyer B, Kreutzer J, Krieg S . Hollow screws: a diagnostic tool for intracranial empyema. Acta Neurochir (Wien). 2012; 155(2):373-7. DOI: 10.1007/s00701-012-1581-0. View

Niklewski F, Petridis A, Al Hourani J, Blaeser K, Ntoulias G, Bitter A . Pediatric parafalcine empyemas. J Surg Case Rep. 2014; 2013(8). PMC: 3813702. DOI: 10.1093/jscr/rjt067. View

Benevides G, Salgado Jr G, Ferreira C, Felipe-Silva A, Gilio A . Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome. Autops Case Rep. 2016; 5(4):19-26. PMC: 4757916. DOI: 10.4322/acr.2015.029. View

Vijayakumar B, Sarin K, Mohan G . Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus. Ann Indian Acad Neurol. 2012; 15(2):130-3. PMC: 3345591. DOI: 10.4103/0972-2327.94998. View

Banerjee A, Pandey P, Ambekar S, Chandramouli B . Pediatric intracranial subdural empyema caused by Mycobacterium tuberculosis--a case report and review of literature. Childs Nerv Syst. 2010; 26(8):1117-20. DOI: 10.1007/s00381-010-1157-3. View

Neromyliotis E, Giakoumettis D, Drosos E, Nikas I, Blionas A, Sfakianos G . Pediatric infratentorial subdural empyema: A case report. Surg Neurol Int. 2018; 9:104. PMC: 5991265. DOI: 10.4103/sni.sni_394_17. View

10.

Garlick R . Subdural empyema. Br Med J (Clin Res Ed). 1986; 293(6542):336-7. PMC: 1341021. DOI: 10.1136/bmj.293.6542.336-c. View

11.

Patel N, Garber D, Hu S, Kamat A . Systematic review and case report: Intracranial complications of pediatric sinusitis. Int J Pediatr Otorhinolaryngol. 2016; 86:200-12. DOI: 10.1016/j.ijporl.2016.05.009. View

12.

Yilmaz N, Kiymaz N, Yilmaz C, Bay A, Ari Yuca S, Mumcu C . Surgical treatment outcome of subdural empyema: A clinical study. Pediatr Neurosurg. 2006; 42(5):293-8. DOI: 10.1159/000094065. View

13.

Legrand M, Roujeau T, Meyer P, Carli P, Orliaguet G, Blanot S . Paediatric intracranial empyema: differences according to age. Eur J Pediatr. 2009; 168(10):1235-41. DOI: 10.1007/s00431-008-0918-4. View

14.

Bok A, Peter J . Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. J Neurosurg. 1993; 78(4):574-8. DOI: 10.3171/jns.1993.78.4.0574. View

15.

SMITH H, HENDRICK E . Subdural empyema and epidural abscess in children. J Neurosurg. 1983; 58(3):392-7. DOI: 10.3171/jns.1983.58.3.0392. View

16.

Lefebvre L, Metellus P, Dufour H, Bruder N . Linezolid for treatment of subdural empyema due to Streptococcus: case reports. Surg Neurol. 2008; 71(1):89-91. DOI: 10.1016/j.surneu.2007.06.083. View

17.

Kanu O, Nnoli C, Olowoyeye O, Ojo O, Esezobor C, Adeyomoye A . Infantile subdural empyema: The role of brain sonography and percutaneous subdural tapping in a resource-challenged region. J Neurosci Rural Pract. 2014; 5(4):355-9. PMC: 4173231. DOI: 10.4103/0976-3147.139978. View

18.

Madhugiri V, Savitr Sastri B, Bhagavatula I, Sampath S, Chandramouli B, Pandey P . Posterior fossa subdural empyema in children--management and outcome. Childs Nerv Syst. 2010; 27(1):137-44. DOI: 10.1007/s00381-010-1169-z. View

19.

Mahapatra A, Bhatia R . Salmonella intracerebral and subdural abscess--report of two cases. Postgrad Med J. 1987; 63(739):373-5. PMC: 2428484. DOI: 10.1136/pgmj.63.739.373. View

20.

GARFIELD J . Management of supratentorial intracranial abscess: a review of 200 cases. Br Med J. 1969; 2(5648):7-11. PMC: 1983029. DOI: 10.1136/bmj.2.5648.7. View