Subdural empyema secondary to sinus infection in children

Childs Nerv Syst. 2009 Feb;25(2):199-205. doi: 10.1007/s00381-008-0665-x. Epub 2008 Jun 25.

Abstract

Objective: To evaluate the impact, on morbidity and mortality, of aggressive surgical management of subdural empyema of sinus origin in children.

Method: The authors conducted a retrospective review of 20 children admitted between 2000-2007 to Alder Hay Children Hospital and The Walton centre for Neurology and Neurosurgery for subdural empyema secondary to sinus infection. Clinical presentation, duration of symptoms, radiological investigations, surgical treatment and post-operative outcome were evaluated.

Results: Outcome was favourable in 19 cases. In four cases, there were re-accumulation requiring surgical evacuation, four patients experienced post-operative seizures but were seizure-free at follow-up. There was only one mortality in the series.

Conclusion: Subdural empyema secondary to sinus infection, although uncommon, it could be associated with a relative high morbidity and mortality rate. Early aggressive surgical and medical management with drainage of intracranial or sinus collections and antibiotics therapy lead to a low mortality or morbidity rate and good clinical outcome.

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / complications*
  • Child
  • Drainage / methods
  • Empyema, Subdural / diagnosis*
  • Empyema, Subdural / etiology
  • Empyema, Subdural / therapy
  • Follow-Up Studies
  • Humans
  • Injections, Intravenous
  • Magnetic Resonance Imaging / methods
  • Retrospective Studies
  • Sinusitis / complications*
  • Streptococcal Infections / complications
  • Tomography Scanners, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents