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© Georg Thieme Verlag KG Stuttgart · New York
Continuous Subdural Irrigation and Drainage for Intracranial Subdural Empyema in a 92-Year-Old Woman
07 June 2011 (online)
Introduction: Intracranial subdural empyema (ISDE) is a life-threatening intracranial infection. Early and precise detection, timely surgery, and appropriate antibiotic therapy are the keys to a more favorable clinical outcome. Treatment is aimed at complete evacuation of the empyema and eradication of the source of infection. However, in the case of elderly patients or patients with poor health, doctors hesitate to perform open cranial surgery under general anesthesia; thus, the choice of appropriate surgical method is fraught with many limitations.
Case Report: We present a case of ISDE in a 92-year-old woman who was successfully treated with continuous irrigation of the subdural space with antibiotics and drainage through 2 burr holes for 1 week without any complications.
Conclusion: Continuous subdural irrigation is useful for the evacuation of pus and eradication of the source of infection, thereby resulting in a favorable outcome, especially in elderly patients and patients with poor health.
intracranial subdural empyema - continuous irrigation - old age
- 1 Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ. et al . Two surgical methods used in 90 patients with intracranial subdural empyema. J Clin Neurosci. 2009; 16 1567-1571
- 2 Wong AM, Zimmerman RA, Simon EM. et al . Diffusion-weighted MR imaging of subdural empyemas in children. Am J Neuroradiol. 2004; 25 1016-1021
- 3 Agrawal A, Timothy J, Pandit L. et al . A review of subdural empyema and its management. Infect Dis Clin Pract. 2007; 15 149-153
- 4 Nathoo N, Nadvi SS, Gouws E. et al . Craniotomy improves outcomes for cranial subdural empyemas: computed tomography-era experience with 699 patients. Neurosurgery. 2001; 49 872-877
- 5 Tewari MK, Sharma RR, Shiv VK. et al . Spectrum of intracranial subdural empyemas in a series of 45 patients: current surgical options and outcome. Neurol India. 2004; 52 346-349
- 6 Nathoo N, Nadvi SS, Royston D. et al . Cerebral blood flow changes in rhinogenic subdural empyema and the role of hyperaemia in brain swelling. East Afr Med J. 2000; 77 359-363
- 7 Wada Y, Kubo T, Asano T. et al . Fulminant subdural empyema treated with a wide decompressive craniectomy and continuous irrigation – case report. Neurol Med Chir (Tokyo). 2002; 42 414-416
- 8 Shearman CP, Lees PD, Taylor JC. Subdural empyema: a rational management plan. The case against craniotomy. Br J Neurosurg. 1987; 1 179-183
- 9 Joubert MJ, Stephanov S. Computerised tomography and surgical treatment in intracranial suppuration. J Neurosurg. 1977; 47 73-78
- 10 Greenlee JE. Subdural empyema. Curr Treat Options Neurol. 2003; 5 13-22
T. Y. KimMD, PhD
Department of Neurosurgery
Wonkwang University School of
Phone: +82/63/859 1462
Fax: +82/63/852 2606