Subdural empyema history and symptoms: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
The most common presentation of subdural empyema is a clinical triad of: | The most common presentation of subdural empyema is a clinical triad of: | ||
#[[Fever]] | #[[Fever]] >38 ºC (100.5 ºF) | ||
#[[Sinusitis]] | #[[Sinusitis]] | ||
| Line 17: | Line 17: | ||
However, other symptoms may include: | However, other symptoms may include: | ||
*[[nausea]]/[[vomiting]] | *[[nausea]]/[[vomiting]] | ||
*[[headache]], initially focal, slowly progressing into a diffuse type | *[[headache]], initially focal, slowly progressing into a diffuse type | ||
*[[seizures]] | *[[seizures]] | ||
*mental status changes | *mental status changes | ||
*[[drowsiness]] | *[[drowsiness]] | ||
*[[stupor]] | *[[stupor]] | ||
*Afasia, if the dominant hemisphere is affected | |||
*Palsy of the 3rd and 6th cranial nerve | |||
*Contralateral motor deficits | |||
*[[coma]] | *[[coma]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: 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.[1] It consists of a localised collection of purulent material, usually unilateral, between the dura mater and the arachnoid mater and 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 diagnosis of subdural empyema is based on clinical suspicion.[1] Symptoms include those referable to the source of the infection. In addition, most patients are febrile, with headache and neck stiffness, and, if untreated, may develop focal neurologic signs, lethargy, and coma.
History and Symptoms
The most common presentation of subdural empyema is a clinical triad of:
- Fever >38 ºC (100.5 ºF)
- Neurological deficits, with a fast downhill course
However, other symptoms may include:
- nausea/vomiting
- headache, initially focal, slowly progressing into a diffuse type
- seizures
- mental status changes
- drowsiness
- stupor
- Afasia, if the dominant hemisphere is affected
- Palsy of the 3rd and 6th cranial nerve
- Contralateral motor deficits
- coma
References
- ↑ 1.0 1.1 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.
- ↑ Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.