Subdural empyema history and symptoms: Difference between revisions
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*[[nausea]]/[[vomiting]] | *[[nausea]]/[[vomiting]] | ||
*[[headache]], the most common complaint at presentation, initially localized to the side of the subdural infection, slowly progressing into a diffuse type. | *[[headache]], the most common complaint at presentation, initially localized to the side of the subdural infection, slowly progressing into a diffuse type. | ||
*[[seizures]], focal or generalised | *[[seizures]], focal or generalised. May result from the focal irritative effect of the infection on the cortex, or result from cortical venous infarction | ||
*mental status changes | *mental status changes | ||
*[[drowsiness]] | *[[drowsiness]] | ||
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*[[meningismus]] | *[[meningismus]] | ||
*contralateral motor deficits | *contralateral motor deficits | ||
*[[coma]] | *[[coma]], as a result of an untreated subdural empyema, causing an increasing [[mass effect]] and increase in [[intracranial pressure]]. | ||
==References== | ==References== | ||
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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 should be suspected, when a patient presents with a history of sinusitis and recent CNS signs and/or symptoms.[1][3] 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:
However, other symptoms may include:
- nausea/vomiting
- headache, the most common complaint at presentation, initially localized to the side of the subdural infection, slowly progressing into a diffuse type.
- seizures, focal or generalised. May result from the focal irritative effect of the infection on the cortex, or result from cortical venous infarction
- mental status changes
- drowsiness
- stupor
- aphasia, if the dominant hemisphere is affected
- palsy of the 3rd and 6th cranial nerves
- meningismus
- contralateral motor deficits
- coma, as a result of an untreated subdural empyema, causing an increasing mass effect and increase in intracranial pressure.
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.
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.