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Erschienen in: Child's Nervous System 10/2018

16.07.2018 | Special Annual Issue

Subdural empyema in children

verfasst von: Dattatraya Muzumdar, Naresh Biyani, Chandrashekhar Deopujari

Erschienen in: Child's Nervous System | Ausgabe 10/2018

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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.
Literatur
1.
Zurück zum Zitat Khan M, Griebel R (1984) Subdural empyema: a retrospective study of 15 patients. Can J Surg 27:283–288PubMed Khan M, Griebel R (1984) Subdural empyema: a retrospective study of 15 patients. Can J Surg 27:283–288PubMed
2.
3.
Zurück zum Zitat Liu ZH, Chen NY, Tu PH, Lee ST, Wu CT (2010) The treatment and outcome of postmeningitic subdural empyema in infants. J Neurosurg Pediatr 6(1):38–42CrossRefPubMed Liu ZH, Chen NY, Tu PH, Lee ST, Wu CT (2010) The treatment and outcome of postmeningitic subdural empyema in infants. J Neurosurg Pediatr 6(1):38–42CrossRefPubMed
4.
Zurück zum Zitat De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A (2009) Cranial and spinal subdural empyema. Br J Neurosurg 23(3):335–340CrossRefPubMed De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A (2009) Cranial and spinal subdural empyema. Br J Neurosurg 23(3):335–340CrossRefPubMed
5.
Zurück zum Zitat Agrawal A, Timothy J, Pandit L, Shetty L, Shetty JP (2007) A review of subdural empyema and its management. Infect Dis Clin Pract (Baltim Md) 15(3):149–153CrossRef Agrawal A, Timothy J, Pandit L, Shetty L, Shetty JP (2007) A review of subdural empyema and its management. Infect Dis Clin Pract (Baltim Md) 15(3):149–153CrossRef
6.
Zurück zum Zitat Pathak A, Sharma BS, Mathuriya SN, Khosla VK, Khandelwal N, Kak VK (1990) Controversies in the management of subdural empyema. A study of 41 cases with review of literature. Acta Neurochir 102:25–32CrossRefPubMed Pathak A, Sharma BS, Mathuriya SN, Khosla VK, Khandelwal N, Kak VK (1990) Controversies in the management of subdural empyema. A study of 41 cases with review of literature. Acta Neurochir 102:25–32CrossRefPubMed
7.
Zurück zum Zitat Venkatesh MS, Pandey P, Devi BI, Khanapure K, Satish S, Sampath S, Chandramouli BA, Sastry KV (2006) Pediatric infratentorial subdural empyema: analysis of 14 cases. J Neurosurg 105:370–377PubMed Venkatesh MS, Pandey P, Devi BI, Khanapure K, Satish S, Sampath S, Chandramouli BA, Sastry KV (2006) Pediatric infratentorial subdural empyema: analysis of 14 cases. J Neurosurg 105:370–377PubMed
8.
Zurück zum Zitat Patel NA, Garber D, Hu S, Kamat A (2016) Systematic review and case report: intracranial complications of pediatric sinusitis. Int J Pediatr Otorhinolaryngol 86:200–212CrossRefPubMed Patel NA, Garber D, Hu S, Kamat A (2016) Systematic review and case report: intracranial complications of pediatric sinusitis. Int J Pediatr Otorhinolaryngol 86:200–212CrossRefPubMed
9.
Zurück zum Zitat Benevides GN, Salgado GA Jr, Ferreira CR, Felipe-Silva A, Gilio AE (2015) Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome. Autops Case Rep 5:19–26CrossRefPubMedPubMedCentral Benevides GN, Salgado GA Jr, Ferreira CR, Felipe-Silva A, Gilio AE (2015) Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome. Autops Case Rep 5:19–26CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Germiller JA, Sparano AM (2006) Intracranial complications of sinusitis in children and adolescents and their outcomes. Arch Otolaryngol Head Neck Surg 132:969–976CrossRefPubMed Germiller JA, Sparano AM (2006) Intracranial complications of sinusitis in children and adolescents and their outcomes. Arch Otolaryngol Head Neck Surg 132:969–976CrossRefPubMed
11.
Zurück zum Zitat Cowie R, Williams B (1983) Late seizures and morbidity after subdural empyema. J Neurosurg 58:569–573CrossRefPubMed Cowie R, Williams B (1983) Late seizures and morbidity after subdural empyema. J Neurosurg 58:569–573CrossRefPubMed
12.
Zurück zum Zitat Niklewski F, Petridis AK, Al Hourani J, Blaeser K, Ntoulias G, Bitter A, Rosenbaum T, Scholz M (2013) Pediatric parafalcine empyemas. J Surg Case Rep Aug 29:2013(8) Niklewski F, Petridis AK, Al Hourani J, Blaeser K, Ntoulias G, Bitter A, Rosenbaum T, Scholz M (2013) Pediatric parafalcine empyemas. J Surg Case Rep Aug 29:2013(8)
15.
Zurück zum Zitat Williams B (1982) Subdural empyema. In: Krayenbuhl H et al (eds) Advances and technical standards in neurosurgery, vol Vol 9. Springer, Wien New York, pp 133–170CrossRef Williams B (1982) Subdural empyema. In: Krayenbuhl H et al (eds) Advances and technical standards in neurosurgery, vol Vol 9. Springer, Wien New York, pp 133–170CrossRef
16.
Zurück zum Zitat Turel MK, Moorthy RK, Rajshekhar V (2012) Multidrug-resistant tuberculous subdural empyema with secondary methicillin-resistant Staphylococcus aureus infection: an unusual presentation of cranial tuberculosis in an infant. Neurol India 60(2):231–234CrossRefPubMed Turel MK, Moorthy RK, Rajshekhar V (2012) Multidrug-resistant tuberculous subdural empyema with secondary methicillin-resistant Staphylococcus aureus infection: an unusual presentation of cranial tuberculosis in an infant. Neurol India 60(2):231–234CrossRefPubMed
17.
Zurück zum Zitat Vijayakumar B, Sarin K, Mohan G (2012) Tuberculous brain abscess and subdural empyema in an immunocompetent child: significance of AFB staining in aspirated pus. Ann Indian Acad Neurol 15(2):130–133CrossRefPubMedPubMedCentral Vijayakumar B, Sarin K, Mohan G (2012) Tuberculous brain abscess and subdural empyema in an immunocompetent child: significance of AFB staining in aspirated pus. Ann Indian Acad Neurol 15(2):130–133CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Banerjee AD, Pandey P, Ambekar S, Chandramouli BA (2010) Pediatric intracranial subdural empyema caused by Mycobacterium tuberculosis—a case report and review of literature. Childs Nerv Syst 26(8):1117–1120CrossRefPubMed Banerjee AD, Pandey P, Ambekar S, Chandramouli BA (2010) Pediatric intracranial subdural empyema caused by Mycobacterium tuberculosis—a case report and review of literature. Childs Nerv Syst 26(8):1117–1120CrossRefPubMed
19.
Zurück zum Zitat Dwarakanath S, Suri A, Mahapatra AK (2004) Spontaneous subdural empyema in falciparum malaria: a case study. J Vector Borne Dis 41(3–4):80–82PubMed Dwarakanath S, Suri A, Mahapatra AK (2004) Spontaneous subdural empyema in falciparum malaria: a case study. J Vector Borne Dis 41(3–4):80–82PubMed
21.
Zurück zum Zitat Surinder K, Bineeta K, Megha M (2007) Latex particle agglutination test as an adjunct to the diagnosis of bacterial meningitis. Indian J Med Microbiol 25(4):395–397CrossRefPubMed Surinder K, Bineeta K, Megha M (2007) Latex particle agglutination test as an adjunct to the diagnosis of bacterial meningitis. Indian J Med Microbiol 25(4):395–397CrossRefPubMed
22.
Zurück zum Zitat Kanu OO, Nnoli C, Olowoyeye O, Ojo O, Esezobor C, Adeyomoye A, Bankole O, Asoegwu C, Temiye E (2014) Infantile subdural empyema: the role of brain sonography and percutaneous subdural tapping in a resource-challenged region. J Neurosci Rural Pract 5(4):355–359CrossRefPubMedPubMedCentral Kanu OO, Nnoli C, Olowoyeye O, Ojo O, Esezobor C, Adeyomoye A, Bankole O, Asoegwu C, Temiye E (2014) Infantile subdural empyema: the role of brain sonography and percutaneous subdural tapping in a resource-challenged region. J Neurosci Rural Pract 5(4):355–359CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Gupta S, Vachhrajani S, Kulkarni AV, Taylor MD, Dirks P, Drake JM, Rutka JT (2011) Neurosurgical management of extraaxial central nervous system infections in children. J Neurosurg Pediatr 7(5):441–451CrossRefPubMed Gupta S, Vachhrajani S, Kulkarni AV, Taylor MD, Dirks P, Drake JM, Rutka JT (2011) Neurosurgical management of extraaxial central nervous system infections in children. J Neurosurg Pediatr 7(5):441–451CrossRefPubMed
24.
Zurück zum Zitat Hendaus MA (2013) Subdural empyema in children. Glob J Health Sci 14; 5(6):54–59 Hendaus MA (2013) Subdural empyema in children. Glob J Health Sci 14; 5(6):54–59
25.
Zurück zum Zitat Waseem M, Khan S, Bomann S (2008) Subdural empyema complicating sinusitis. J Emerg Med 35(3):277–281CrossRefPubMed Waseem M, Khan S, Bomann S (2008) Subdural empyema complicating sinusitis. J Emerg Med 35(3):277–281CrossRefPubMed
26.
27.
Zurück zum Zitat Prober CG, Bachrach LK, Humphreys RP, Hendrick BE, Mehten KG, Rapley WA (1985) An unusual case of intracranial suppuration. Pediatr Infect Dis J 4:101–103CrossRef Prober CG, Bachrach LK, Humphreys RP, Hendrick BE, Mehten KG, Rapley WA (1985) An unusual case of intracranial suppuration. Pediatr Infect Dis J 4:101–103CrossRef
28.
Zurück zum Zitat Hodges J, Anslaw P, Gillett G (1986) Subdural empyema—continuing diagnostic problem in the CT scan era. Q J Med (NS) 59(228):387–393 Hodges J, Anslaw P, Gillett G (1986) Subdural empyema—continuing diagnostic problem in the CT scan era. Q J Med (NS) 59(228):387–393
29.
Zurück zum Zitat Bruner DI, Littlejohn L, Pritchard A (2012) Subdural empyema presenting with seizure, confusion, and focal weakness. West J Emerg Med 13(6):509–511CrossRefPubMedPubMedCentral Bruner DI, Littlejohn L, Pritchard A (2012) Subdural empyema presenting with seizure, confusion, and focal weakness. West J Emerg Med 13(6):509–511CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Aldinger FA, Shiban E, Gempt J, Meyer B, Kreutzer J, Krieg SM (2013) Hollow screws: a diagnostic tool for intracranial empyema. Acta Neurochir 155(2):373–377CrossRefPubMed Aldinger FA, Shiban E, Gempt J, Meyer B, Kreutzer J, Krieg SM (2013) Hollow screws: a diagnostic tool for intracranial empyema. Acta Neurochir 155(2):373–377CrossRefPubMed
31.
Zurück zum Zitat Wu TJ, Chiu NC, Huang FY (2008) Subdural empyema in children—20-year experience in a medical center. J Microbiol Immunol Infect 41(1):62–67PubMed Wu TJ, Chiu NC, Huang FY (2008) Subdural empyema in children—20-year experience in a medical center. J Microbiol Immunol Infect 41(1):62–67PubMed
32.
Zurück zum Zitat Lefebvre L, Metellus P, Dufour H, Bruder N (2009) Linezolid for treatment of subdural empyema due to Streptococcus: case reports. Surg Neurol 71(1):89–91CrossRefPubMed Lefebvre L, Metellus P, Dufour H, Bruder N (2009) Linezolid for treatment of subdural empyema due to Streptococcus: case reports. Surg Neurol 71(1):89–91CrossRefPubMed
33.
Zurück zum Zitat Madhugiri VS, Sastri BV, Bhagavatula ID, Sampath S, Chandramouli BA, Pandey P (2011) Posterior fossa subdural empyema in children—management and outcome. Childs Nerv Syst 27:137–144CrossRefPubMed Madhugiri VS, Sastri BV, Bhagavatula ID, Sampath S, Chandramouli BA, Pandey P (2011) Posterior fossa subdural empyema in children—management and outcome. Childs Nerv Syst 27:137–144CrossRefPubMed
34.
Zurück zum Zitat Mauser HW, Ravijst RAP, Elderson A, van Gijn J, Tulleken CAF (1985) Nonsurgical treatment of subdural empyema. Case report. J Neurosurg 63:128–130CrossRefPubMed Mauser HW, Ravijst RAP, Elderson A, van Gijn J, Tulleken CAF (1985) Nonsurgical treatment of subdural empyema. Case report. J Neurosurg 63:128–130CrossRefPubMed
35.
Zurück zum Zitat Jacobson PL, Farmer TW (1981) Subdurai empyema complicating meningitis in infants: improved prognosis. Neurology 31:190–193CrossRefPubMed Jacobson PL, Farmer TW (1981) Subdurai empyema complicating meningitis in infants: improved prognosis. Neurology 31:190–193CrossRefPubMed
37.
Zurück zum Zitat Smith HP, Hendrick EB (1983) Subdural empyema and epidural abscess in children. J Neurosurg 58:392–397CrossRefPubMed Smith HP, Hendrick EB (1983) Subdural empyema and epidural abscess in children. J Neurosurg 58:392–397CrossRefPubMed
38.
Zurück zum Zitat Nathoo N, Nadvi SS, Gouws E, van Dellen JR (2001) Craniotomy improves outcomes for cranial empyema in computed tomography era experience with 699 patients. Neurosurgery 49(4):872–878PubMed Nathoo N, Nadvi SS, Gouws E, van Dellen JR (2001) Craniotomy improves outcomes for cranial empyema in computed tomography era experience with 699 patients. Neurosurgery 49(4):872–878PubMed
39.
Zurück zum Zitat Salunke PS, Malik V, Kovai P, Mukherjee KK (2011) Falcotentorial subdural empyema: analysis of 10 cases. Acta Neurochir 153(1):164–169CrossRefPubMed Salunke PS, Malik V, Kovai P, Mukherjee KK (2011) Falcotentorial subdural empyema: analysis of 10 cases. Acta Neurochir 153(1):164–169CrossRefPubMed
40.
Zurück zum Zitat Neromyliotis E, Giakoumettis D, Drosos E, Nikas I, Blionas A, Sfakianos G, Themistocleous MS (2018) Pediatric infratentorial subdural empyema: a case report. Surg Neurol Int 24(9):104 Neromyliotis E, Giakoumettis D, Drosos E, Nikas I, Blionas A, Sfakianos G, Themistocleous MS (2018) Pediatric infratentorial subdural empyema: a case report. Surg Neurol Int 24(9):104
41.
Zurück zum Zitat Mohindra S, Kursa GK, Reddy R (2015) Bilateral symmetrical infratentorial subdural empyema: delay proves detrimental. J Pediatr Neurosci 10(3):285–286CrossRefPubMedPubMedCentral Mohindra S, Kursa GK, Reddy R (2015) Bilateral symmetrical infratentorial subdural empyema: delay proves detrimental. J Pediatr Neurosci 10(3):285–286CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Yilmaz N, Kiymaz N, Yilmaz C, Bay A, Yuca SA, Mumcu C, Caksen H (2006) Surgical treatment outcome of subdural empyema: a clinical study. Pediatr Neurosurg 42(5):293–298CrossRefPubMed Yilmaz N, Kiymaz N, Yilmaz C, Bay A, Yuca SA, Mumcu C, Caksen H (2006) Surgical treatment outcome of subdural empyema: a clinical study. Pediatr Neurosurg 42(5):293–298CrossRefPubMed
43.
Zurück zum Zitat Bok AP, Peter JC (1993) Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. J Neurosurg 78:574–578CrossRefPubMed Bok AP, Peter JC (1993) Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. J Neurosurg 78:574–578CrossRefPubMed
44.
Zurück zum Zitat Legrand M, Roujeau T, Meyer P, Carli P, Orliaguet G, Blanot S (2009) Paediatric intracranial empyema: differences according to age. Eur J Pediatr 168(10):1235–1241CrossRefPubMed Legrand M, Roujeau T, Meyer P, Carli P, Orliaguet G, Blanot S (2009) Paediatric intracranial empyema: differences according to age. Eur J Pediatr 168(10):1235–1241CrossRefPubMed
Metadaten
Titel
Subdural empyema in children
verfasst von
Dattatraya Muzumdar
Naresh Biyani
Chandrashekhar Deopujari
Publikationsdatum
16.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 10/2018
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-3907-6

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