Spectrum of intracranial subdural empyemas in a series of 45 patients: current surgical options and outcome

Neurol India. 2004 Sep;52(3):346-9.

Abstract

Background: The subject of subdural empyema (SDE) is reviewed on the basis of experience with 45 cases.

Methods: Records of 45 patients with SDE were analyzed. There were 35 males and 10 females in the series. The majority of the patients were either infants (22.2%) or in their second and third decade of life (37.8%). For supratentorial SDE, craniotomy was done in 5 cases (11.1%). In six cases (13.3%) two burr-holes and in the rest of the cases multiple burrholes were done to evacuate the empyema. Craniectomy was done in three cases (6.7%), of which two had posterior fossa SDE. All patients received appropriate preoperative and postoperative broad-spectrum antibiotics.

Results: There was good recovery in 35 (77.8%) patients, six patients (13.3%) had moderate disability, two patients (4.4%) had severe disability, and two (4.4%) died. Three patients who developed recollection at operation site required evacuation of residual SDE. Median follow-up was 3(1/2) years (range 4 months to 3(1/2) years).

Conclusion: Emergent evacuation of SDE using multiple burr-holes and irrigation of the subdural cavity with saline for 24 hours results in a satisfactory outcome in cases with SDE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Craniotomy
  • Empyema, Subdural / diagnosis
  • Empyema, Subdural / pathology
  • Empyema, Subdural / surgery*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neurosurgical Procedures*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome