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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2025; 44(01): e29-e35
DOI: 10.1055/s-0045-1801861
Review Article

Subdural Empyema, an Intracranial Sinus Complication

Empiema subdural, uma complicação intracraniana sinusal
Rafaela Pádua Manicardi 
1   Faculdade Atenas, Passos, MG, Brazil
,
Gabrielle Freitas Ribeiro
1   Faculdade Atenas, Passos, MG, Brazil
,
Stephanie Cunha Soares 
1   Faculdade Atenas, Passos, MG, Brazil
,
Ana Flávia Borges Carvalho e Silva
1   Faculdade Atenas, Passos, MG, Brazil
,
Ana Clara Pinto Orlandi Queiros
1   Faculdade Atenas, Passos, MG, Brazil
,
Nicollas Nunes Rabelo
2   Department of Neurosurgery, Centro Universitário Atenas (UniAtenas), Paracatu, MG, Brazil
› Author Affiliations
Funding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.
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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.

Keywords

subdural empyema - sinusitis - intracranial complication

Palavras chaves

empiema subdural - sinusite - complicação intracraniana


Publication History

Received: 17 September 2023

Accepted: 23 October 2024

Article published online:
27 March 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/)

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