Intracranial Epidural Abscess And Subduralempyem

An epidural abscess is a collection of pus between the dura mater and the skull. Subdural empyema is a collection of pus between the dura mater and arachnoid. The symptoms of epidural abscess include fever, headache, vomiting, sometimes lethargy, focal neurological deficits, seizures, and / or coma with one. The symptoms of Subduralempyem include fever, vomiting, altered consciousness and rapid development of neurological signs of far-flung involvement of a cerebral hemisphere. The diagnosis is made if not available, a contrast-enhanced CT using a contrast-enhanced MRI, or. The treatment is effected by means of surgical drainage and antibiotics.

An epidural abscess is a collection of pus between the dura mater and the skull. Subdural empyema is a collection of pus between the dura mater and arachnoid. The symptoms of epidural abscess include fever, headache, vomiting, sometimes lethargy, focal neurological deficits, seizures, and / or coma with one. The symptoms of Subduralempyem include fever, vomiting, altered consciousness and rapid development of neurological signs of far-flung involvement of a cerebral hemisphere. The diagnosis is made if not available, a contrast-enhanced CT using a contrast-enhanced MRI, or. The treatment is effected by means of surgical drainage and antibiotics. Etiology A cranial epidural abscesses and subdural empyema are usually complications of sinusitis (v. A. Frontal sinusitis, ethmoid and sphenoid), but they can also ear infections, head trauma or -operation or, rarely, follow bacteremia. The excitation spectrum is similar to brain abscesses (brain abscess: etiology). In children <5 years, the most common cause is a bacterial meningitis; because meningitis is rare today in childhood, an infantile subdural empyema is uncommon. Complications An epidural abscess may spread into the subdural space, causing a Subduralempyem. Both the epidural abscess and the Subduralempyem can develop into meningitis, cortical vein thrombosis or brain abscess. Subduralempyeme can spread rapidly over an entire cerebral hemisphere. Symptoms and signs fever, headache, lethargy, focal neurological deficits (often suggest a Subduralempyem when rapidly developing deficits on an extensive involvement of a cerebral hemisphere point) and seizures develop over several days. Patients with intracranial epidural abscess may also develop a subperiosteal abscesses and osteomyelitis of the frontal bone (Pott puffy tumor), and patients with Subduralempyem develop meningeal signs. In epidural Anszess and Subduralempyem meningism, vomiting and papilledema are common. Without treatment, it comes quickly to coma and death. Diagnostic contrast-enhanced MRI is diagnosed if not available, a contrast-enhanced CT using a contrast-enhanced MRI, or. Blood cultures and surgically removed biopsies are aerobic and anaerobic cultivated. A lumbar puncture offers little useful information and may cause transtentorial strangulation. When an intracranial abscess or subdural empyema (z. B. on a duration of symptoms for several days, focal deficits or risk factors based) is contraindicated in patients with a lumbar puncture meningism until a neuroradiological imaging excludes a space-occupying lesion. In infants, a subdural puncture for the diagnosis can be carried out and relieve intracranial pressure. Treatment Surgical drainage antibiotics should be performed even emergency drainage of the epidural abscess or Subduralempyems and the possible underlying sinusitis. Depending on the results of the culture is the antibiotic coverage the same as the brain abscess, except for young children who need antibiotics for possible accompanying meningitis (see table: Initial antibiotics for acute bacterial meningitis and Conventional intravenous doses of antibiotics for acute bacterial meningitis *) , Anticonvulsants and measures to reduce intracranial pressure may be necessary.

Health Life Media Team

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