What causes subdural abscess?

Paranasal sinusitis is the primary cause of a subdural empyema in 50% to 80% of patients, and otitis media is the primary cause in 10% to 20%. Superficial infections of the scalp and skull, craniotomy, or septic thrombophlebitis from sinusitis, otitis, or mastoiditis may extend to the subdural space, causing empyema.

Is a subdural empyema an abscess?

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 is extradural and subdural abscess?

An intracranial epidural abscess is a pocket of pus that develops between the skull and the top layer of tissues (dura mater) covering the brain. A subdural empyema is a pocket of pus that develops between the dura mater and the middle layer of the tissues (arachnoid mater) covering the brain.

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.

What is empyema?

Empyema is the medical term for pockets of pus that have collected inside a body cavity. They can form if a bacterial infection is left untreated, or if it fails to fully respond to treatment. The term empyema is most commonly used to refer to pus-filled pockets that develop in the pleural space.

Can a fungal ear infection spread to the brain?

A brain abscess is most likely to result from a bacterial or fungal infection in some part of the brain.

Why does subdural empyema cause increased intracranial pressure?

Subdural empyema produces increased intracranial pressure because of mass effect, cerebral edema, and vasculitis. Vasculitis leads to thrombosis of cortical veins, resulting in focal neurological dysfunction and increased intracranial pressure.

Which is the best treatment for subdural empyema?

The treatment of subdural or epidural empyema requires corticosteroids to decrease ICP, antimicrobials to eradicate the organisms, and anticonvulsants for seizures. Medical therapy and CT to monitor progress may replace surgical drainage of subdural empyema in some situations.

What kind of bacteria can cause spinal empyema?

Spinal subdural empyema is a rare condition that usually occurs secondary to metastatic infection from a distant site. 28,29 The most frequent microbial isolate is Staphylococcus aureus, with streptococci, coagulase-negative staphylococci, and gram-negative bacilli found less frequently. 30

How is the etiological organism of a subdural empyema identified?

The etiological organism of a subdural empyema is identified by Gram’s stain and culture of pus obtained either via burr holes or via craniotomy. Neurosurgical evacuation of the empyema, through either burr hole drainage or craniotomy, is the definitive step in the management of this infection and should be done in an emergent manner.