Subdural empyema lumbar puncture

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Template:Subdural Empyema 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 Lumbar Puncture is an invasive procedure which is contraindicated in case of suspicion of subdural empyema and increased intracranial pressure, due to risk of brain herniation and death.[2]

Lumbar Puncture

Spinal fluid, in normal circumstances is sterile, however, changes in cell count, glucose and protein concentrations are usually unspecific. Nevertheless, after increased intracranial pressure has been excluded, the lumbar punter is a useful diagnostic test to rule out meningeal infection. [1]

References

  1. 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.
  2. 2.0 2.1 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.

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