Subdural empyema medical therapy: Difference between revisions

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==Overview==
==Overview==
[[Subdural empyema]], also referred to as ''subdural abscess'', ''pachymeningitis interna''' and '''circumscript meningitis''', is a life-threatening infection, first reported in literature approximately 100 years ago.<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> It consists of a located collection of [[purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]]. It accounts for about 15-22% of the reported focal intracranial [[infections]]. The empyema may develop intracranially (about 95%) or in the spinal canal (about 5%), and in both cases, it constitutes a [[Medical emergency|medical]] and [[Surgical emergency|neurosurgical emergency]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
[[Subdural empyema]], also referred to as ''subdural abscess'', ''pachymeningitis interna''' and '''circumscript meningitis''', is a life-threatening infection, first reported in literature approximately 100 years ago.<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> It consists of a located collection of [[purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]]. It accounts for about 15-22% of the reported focal intracranial [[infections]]. The empyema may develop intracranially (about 95%) or in the spinal canal (about 5%), and in both cases, it constitutes a [[Medical emergency|medical]] and [[Surgical emergency|neurosurgical emergency]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref> The intracranial type tends to behave like an expanding mass, causing clinical symptoms, such as [[fever]], [[lethargy]], [[headache]] and neurological deficits. These result from the extrinsic compression of the brain, caused not only from the [[inflammatory]] mass, but also from the [[inflammation]] of the [[brain]] and [[meninges]].


With treatment, including surgical drainage, resolution of the empyema occurs from the dural side, and, if it is complete, a thickened dura may be the only residual finding.
With treatment, including surgical drainage, resolution of the empyema occurs from the dural side, and, if it is complete, a thickened dura may be the only residual finding.

Revision as of 02:15, 27 February 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; João André Alves Silva, M.D. [2]

Overview

Subdural empyema, also referred to as subdural abscess, pachymeningitis interna' and circumscript meningitis, is a life-threatening infection, first reported in literature approximately 100 years ago.[1] It consists of a located collection of purulent material, usually unilateral, between the dura mater and the arachnoid mater. It accounts for about 15-22% of the reported focal intracranial infections. The empyema may develop intracranially (about 95%) or in the spinal canal (about 5%), and in both cases, it constitutes a medical and neurosurgical emergency.[2] The intracranial type tends to behave like an expanding mass, causing clinical symptoms, such as fever, lethargy, headache and neurological deficits. These result from the extrinsic compression of the brain, caused not only from the inflammatory mass, but also from the inflammation of the brain and meninges.

With treatment, including surgical drainage, resolution of the empyema occurs from the dural side, and, if it is complete, a thickened dura may be the only residual finding.

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References

  1. Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
  2. Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.

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