Subdural empyema

Subdural empyema

Subdural empyema refers to an infected fluid collection in the subdural space. This may develop as a result of sinusitis, mastoiditis or meningitis, and can complicate trauma or surgery . Figure 48.12 shows a subdural empyema associated with osteomyelitis of the frontal bone and associated scalp swelling – Pott’s pu ff y tumour. In empyema, pus will generally collect in the parafalcine region and over the convexity , trigger ing inflammation and thrombosis in the cortical veins, which helps to explain the high mortality of 8–12%. Presentation mimics that of meningitis and cerebral abscess; typical CT appearances are of hypodense or isodense subdural collection, with contrast enhancement at the margins and often swelling and midline shift. Summary box 48.6 Subdural empyema /uni25CF /uni25CF /uni25CF

Presenting features are similar to those of meningitis or cerebral abscess Typically a crescentic collection with a contrast-enhancing rim is evident on CT Drainage is the mainstay of treatment

Subdural empyema

Subdural empyema refers to an infected fluid collection in the subdural space. This may develop as a result of sinusitis, mastoiditis or meningitis, and can complicate trauma or surgery . Figure 48.12 shows a subdural empyema associated with osteomyelitis of the frontal bone and associated scalp swelling – Pott’s pu ff y tumour. In empyema, pus will generally collect in the parafalcine region and over the convexity , trigger ing inflammation and thrombosis in the cortical veins, which helps to explain the high mortality of 8–12%. Presentation mimics that of meningitis and cerebral abscess; typical CT appearances are of hypodense or isodense subdural collection, with contrast enhancement at the margins and often swelling and midline shift. Summary box 48.6 Subdural empyema /uni25CF /uni25CF /uni25CF

Presenting features are similar to those of meningitis or cerebral abscess Typically a crescentic collection with a contrast-enhancing rim is evident on CT Drainage is the mainstay of treatment

Subdural empyema

Subdural empyema refers to an infected fluid collection in the subdural space. This may develop as a result of sinusitis, mastoiditis or meningitis, and can complicate trauma or surgery . Figure 48.12 shows a subdural empyema associated with osteomyelitis of the frontal bone and associated scalp swelling – Pott’s pu ff y tumour. In empyema, pus will generally collect in the parafalcine region and over the convexity , trigger ing inflammation and thrombosis in the cortical veins, which helps to explain the high mortality of 8–12%. Presentation mimics that of meningitis and cerebral abscess; typical CT appearances are of hypodense or isodense subdural collection, with contrast enhancement at the margins and often swelling and midline shift. Summary box 48.6 Subdural empyema /uni25CF /uni25CF /uni25CF

Presenting features are similar to those of meningitis or cerebral abscess Typically a crescentic collection with a contrast-enhancing rim is evident on CT Drainage is the mainstay of treatment