Subdural empyema

Background

• Infection of subdural space, between the arachnoid and dura mater
• Often a complication of sinusitis, or less commonly from otitis media, meningitis, or neurosurgery

Clinical Manifestations

• Fever, headache, focal neurologic deficits, and papilledema
• May have periorbital edema and subgaleal abscess
• Can cause rapid clinical deterioration due to mass effect on brain

Management

• Surgical drainage
• Intravenous antibiotics
• Duration 6 weeks is reasonable if adequate drainage, 6-8 weeks otherwise, maybe longer