A Case of Interhemispheric Subdural Empyema

Abstract

A ten-year-old girl with interhemispheric subdural empyema was reported. She was admitted to the hospital complaining of headache, fever and seizures. Lumbar puncture showed leukocytosis (428/3) in CSF and she was given antibiotics for pulurent meningitis. EEG showed slow waves in the right side but CT scan revealed no abnormal findings at the time of admission. She developed left hemiconvulsion and sensory loss in the left toe. CT scan performed 15 days after the onset showed a low density area in the right parafalx region and the enhancement of its margin following contrast medium injection. Craniotomy was performed under the diagnosis of subdural empyema, and the pus was aspirated because total removal of the capsule was not possible. The patient was discharged 13 days after the operation without neurological dificits and seizures. Value of serial CT scan for diagnoses of subdural empyema was stressed. The beneficial effects of surgical treatment through an ample craniotomy were discussed.