RSS-Feed abonnieren

DOI: 10.1055/s-0045-1801861
Subdural Empyema, an Intracranial Sinus Complication
Empiema subdural, uma complicação intracraniana sinusalFunding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.

Abstract
Subdural empyema is the most common intracranial complication in sinusitis, defined as an infection with purulent collection between the inner surface of the dura mater and the outer surface of the cerebral arachnoid. This condition is underestimated and neglected by physicians due to its low incidence. However, despite its rarity, it is a serious pathology, requiring early diagnosis and therapeutic management. The present work aims to emphasize sinusitis as the primary focus of subdural empyema and the importance of its eradication for treatment.
Scientific articles published in the past 15 years on PubMed, SciELO, and BVS databases were reviewed using the keywords sinusitis, subdural empyema, and intracranial complication, and selected according to the inclusion criteria: case reports and retrospective studies from 2008 to 2023. At last, 16 works were selected. According to the reviewed articles, sinusopathy should not be underestimated, and more attention should be given to clinical signs suggestive of intracranial infections.
In conclusion, despite being uncommon, subdural empyema resulting from sinusitis complications is a neurosurgical emergency that carries considerable morbidity and mortality rates. Therefore, physicians should be aware of its correct treatment. Lastly, it was observed that otorhinolaryngological procedures can be performed to eliminate the primary focus, while neurosurgical interventions can solve this pathology. Thus, it is impossible to deny the importance of new studies with clear analysis regarding the eradication of the primary focus.
Resumo
O empiema subdural se traduz como a complicação intracraniana mais comum da sinusite, sendo definido como uma infecção cuja coleção purulenta se localiza entre a superfície interna da dura-máter e a superfície externa da aracnoide cerebral. Essa condição é subestimada e negligenciada por médicos, devido a sua baixa incidência. Entretanto, apesar de rara, essa patologia é grave e requer um diagnóstico e uma abordagem terapêutica precoce. O objetivo do presente trabalho é reforçar a sinusite como foco primário do empiema subdural e a importância da sua erradicação para o tratamento.
Foram revisados os artigos científicos publicados nos últimos 15 anos nas bases de dados PubMed, SciELO e BVS, usando os descritores: sinusitis, subdural empyema e intracranial complication, e selecionando os estudos de acordo com os critérios de inclusão: relatos de caso e estudos retrospectivos de 2008 a 2023. Por fim, foram selecionados 16 trabalhos. Conforme os artigos estudados, não a sinusopatia não pode ser subestimada e os sinais clínicos sugestivos de infecções intracranianas devem receber mais atenção.
Conclui-se que, apesar de incomum, o empiema subdural advindo de complicações da sinusite é uma emergência neurocirúrgica com morbidade e mortalidade consideráveis. Assim, os médicos devem se atentar ao seu tratamento correto. Por fim, procedimentos otorrinolaringológicos podem ser feitos para erradicar o foco primário, enquanto intervenções neurocirúrgicas podem solucionar essa patologia. Portanto, é inegável a importância de novos estudos com uma análise esclarecedora referente à erradicação do foco primário.
Publikationsverlauf
Eingereicht: 17. September 2023
Angenommen: 23. Oktober 2024
Artikel online veröffentlicht:
27. März 2025
© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Sung J, Kwon O, Kim D, Kim K. Bilateral subdural empyemas with meningitis secondary to acute barosinusitis. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135 (06) 457-459
- 2 Barroso M, Leite B, Paiva K. Empiema subdural recidivante secundário à sinusite bacteriana frontal em um adolescente imunocompetente: relato de caso. [Recurrent subdural empyema secondary to bacterial frontal sinusitis in an immunocompetent teenager: case report] Rev Bras Neurol 2019; 55 (03)
- 3 Szyfter W, Bartochowska A, Borucki Ł, Maciejewski A, Kruk-Zagajewska A. Simultaneous treatment of intracranial complications of paranasal sinusitis. Eur Arch Otorhinolaryngol 2018; 275 (05) 1165-1173
- 4 Waseem M, Khan S, Bomann S. Subdural empyema complicating sinusitis. J Emerg Med 2008; 35 (03) 277-281
- 5 Bruner DI, Littlejohn L, Pritchard A. Subdural empyema presenting with seizure, confusion, and focal weakness. West J Emerg Med 2012; 13 (06) 509-511
- 6 Aljonas C, Watanabe SEC. EMPIEMA SUBDURAL APÓS QUADRO DE RINOSSINUSITE - RELATO DE CASO. [Subdural empyema following rhinosinusitis condition - case report] Rev Uningá 2018; 55 (S1): 66-69
- 7 Belentani FM, Maia MS, Correa JP, Boccallini MCC, Sampaio AAL, Fávero ML. Empiema subdural: complicação de rinossinusite aguda. [Subdural empyema: complication of acute rhinosinusitis] Arq Int Otorrinolaringol 2008; x: 122-125
- 8 Pereira CU, Abud Odo N, Abud Ldo N, Abud Fdo N, Lima FN. Empiema subdural devido a sinusopatias: considerações sobre 11 casos. [Subdural empyema as a consequence of sinus diseases: considerations on 11 cases] JBNC 2018; 11 (01) 11-16
- 9 de Albuquerque Freitas A, Maciel EHB, Arantes EC. et al. Complicações intracranianas de rinossinusite. [Intracranial complications of rhinosinusitis] Rev Med Minas Gerais 2010; 20 (2, Supl 1) S104-S106
- 10 Shen YY, Cheng ZJ, Chai JY. et al. Interhemispheric Subdural Empyema Secondary to Sinusitis in an Adolescent Girl. Chin Med J (Engl) 2018; 131 (24) 2989-2990
- 11 Varas AH, García IS, Galarraga LM, Aguirre MH, Romero JC, Iturbe EB. Empiema subdural secundario a sinusitis. Descripción de un caso pediátrico. [Subdural empyema secondary to sinusitis. A pediatric case report] An Sist Sanit Navar 2011; 34 (03) 519-522
- 12 Rasul FT, Chari A, Iqbal MO. et al. The Case for Early Antibiotic Commencement and Source Control in Paediatric Subdural Empyema: A Single-Centre Retrospective Case Series. Pediatr Neurosurg 2022; 57 (01) 28-34
- 13 Mathon B, Korinek AM. L'empyème sous-dural : une urgence neurochirurgicale sous-estimée. [Subdural empyema: An underestimated neurosurgical emergency] Presse Med 2018; 47 (4 Pt 1): 331-334
- 14 Hicks CW, Weber JG, Reid JR, Moodley M. Identifying and managing intracranial complications of sinusitis in children: a retrospective series. Pediatr Infect Dis J 2011; 30 (03) 222-226
- 15 Nicoli TK, Oinas M, Niemelä M, Mäkitie AA, Atula T. Intracranial Suppurative Complications of Sinusitis. Scand J Surg 2016; 105 (04) 254-262
- 16 Gorman J, Randhawa N, Mendelsohn D, Honey CR, Heran MKS, Appel-Cresswell S. Subdural Empyema. Can J Neurol Sci 2018; 45 (05) 566-567