 |
|
||||
| Home | Login | |||||
| About | Editorial board | Articles
|
NSI Publications
|
Search | Instructions | Online Submission | Subscribe | Videos | Etcetera | Contact |
|
||||||||||||||||||||
|
|
|
Otogenic intracranical suppuration at a rare site - letter to editor.
A 16 years old female was admitted with headache, fever and irritability for 20 days. She had left ear sepsis since her childhood. Examination revealed signs of meningeal irritation. She had no focal or long tract signs. Other systems were normal. CT brain, plain and contrast study [Figure:1a] and [Figure:1b] showed left temporal lobe abscess (stage III) with left sylvian cortical enhancement and anterior and posterior loculated subdural empyema (SDE) in the parafalcine region on left side. Left temporal abcess was tapped and loculated SDE were removed by appropriate craniotomies. Patient had a stormy post operative period for 48 hours and subsequently recovered. Follow up CT [Figure:1c] done on 7th post operative day showed complete resolution of left temporal abcess and marked reduction of SDE. Antibiotics and anticonvulsive medication were continued. After full recovery, she was subjected to mastoidecomy. SDE is often a complication of otitis media1,2 and paranasal sinusitis[3],[4],[5] and constitute to 13-23% of localised intracranial suppuration. The freely moving subdural pus organises into separate pockets,[12] usually over the convexities.3 Rarely, they collect over parafalcine[3],[5] region which is difficult to access surgically, and constitute to 3.2% of localised intracranial suppuration.[10],[11] Medical treatment alone is not adequate in treating SDE and the loculations need to be drained, to prevent chronic suppuration.[3],[10] Reported mortality is 21-35% and morbidity is about 20%.[5] Early diagnosis, prompt surgical intervention with long term antibiotic therapy and eradication of primary source are mandatory for complete recovery as in our case.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||
