Intracranial Subdural Empyema: Clinical Analysis of 12 Cases

Abstract

Objective: The objective of this study is to analyze the clinical data on patients with intracranial
subdural empyema who were treated in our clinic.

Materials and Methods: Hospital records of 12 cases who were treated in our clinic with the
diagnosis of intracranial subdural empyema between 2000 and 2008 were reviewed. Data on
demographic characteristics, predisposing factors, clinical presentation, laboratory tests, imaging
modalities, treatment strategy and outcome were recorded and analyzed.

Results: Of the 12 cases, 10 were male and 2 were female. Mean age was 20, and 9 cases were
younger than 15. Predisposing factor was meningitis in 7 cases, mastoiditis in 2 cases, trauma in 2
cases and surgery in one case. Fever, headache and vomiting were the most common presenting signs
and nuchal rigidity and focal neurological deficits were the most common findings. Pathogen organisms
were isolated in 4 cases. Staphylococcus aureus was the most common causative pathogen. In
7 cases only computed tomography and in 12 cases computed tomography and magnetic resonance
imaging were used for diagnosis. Subdural empyema was located in the left hemisphere in 6 cases
and right hemisphere in 5 cases. Frontoparietal area was the most common location site. In one case
empyema was located infratentorially. Antibiotic regimen was given either in the preoperative or
postoperative period. Complete recovery was observed in 9 cases. 2 cases were discharged with mild
deficits that showed complete recovery in the follow-up period. One patient died.

Conclusion: Intracranial subdural empyema can be asscoiated with high mortality and morbidity.
Satisfactory outcomes can be achieved with early diagnosis and appropriate treatment.