What is the treatment of subdural empyema?

Treatment in virtually all cases of intracranial or spinal subdural empyema requires prompt surgical drainage and antibiotic therapy. Pus from the empyema should always be sent for anaerobic, as well as aerobic, culture.

What is the most common cause of a subdural empyema?

Subdural empyema most often occurs due to the direct extension of local infection. The infection can spread to the intracranial compartment due to the valveless diploic veins of Breschet. As a result, blood may flow in either direction, causing the spread of bacterial infection intracranially.

Is subdural empyema a complication of bacterial meningitis?

Abstract. Subdural empyema (SDE) and cerebrovascular accident (CVA) are uncommon life-threatening complications of bacterial meningitis, which require urgent neurosurgical intervention to prevent adverse outcomes.

What is cerebral empyema?

Subdural empyema (ie, abscess) is an intracranial focal collection of purulent material located between the dura mater and the arachnoid mater. About 95% of subdural empyemas are located within the cranium; most involve the frontal lobe, and 5% involve the spinal neuraxis.

What causes Cerebritis?

Cerebritis (or myelitis) develops with bacterial and fungal infections and may be secondary to meningitis, penetrating injury, or hematogeneous dissemination from systemic infection. Small collections of acute inflammatory cells indicate the start of a bacterial abscess (Fig.

How is subdural empyema diagnosed?

To diagnose an epidural abscess or a subdural empyema, doctors use magnetic resonance imaging (MRI) done after gadolinium is injected intravenously. Gadolinium (an MRI contrast agent) makes abscesses and empyemas easier to see on MRI scans.

How is cerebritis treated?

Brain abscess in the early phase of cerebritis may respond to antimicrobial therapy without surgical drainage. Surgical drainage may be necessary in many patients to ensure adequate therapy and complete resolution of infection. Patients who do not meet the criteria for medical therapy alone require surgery.

Can cerebritis be cured?

When it is caused by infections, treatment consists of medication that will primarily cure the infection. For inflammation, steroids can be used to bring down the swelling. If the swelling appears to have increased to a dangerous level, surgery may be needed to relieve pressure on the brain.

How common is subdural empyema?

Introduction. Intracranial subdural empyema (ISE) is a rare but serious infection of the brain with the purulent collection located within the space between dura and arachnoid mater. Prior to the advent of antibiotics, morbidity, and mortality affected near 100% of patients within 24-48 hours of presentation1-7.

What happens during the cerebritis stage?

The cerebritis phase lasts for 10–14 days, during which time there is progressive development into an abscess with the formation of a thin, peripheral capsule and central necrosis.

What is cerebritis of the brain?

Cerebritis is a term that represents inflammation of the brain in the setting of infection, before the development of a cerebral abscess.