Subdural empyema

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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