Saxena R, Vandertop W P, Küppers G L, van Swieten J C
Afd. Neurologie, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Ned Tijdschr Geneeskd. 2000 Apr 15;144(16):741-5.
A previously healthy man aged 18 years suddenly developed a severe headache, followed by nausea, vomiting, fever. During the following weeks a left-sided hemiparesis developed. CT of the brain revealed a pansinusitis and a frontal epidural empyema. A few days after surgical drainage his condition deteriorated and subsequent CT showed a right-sided subdural empyema. This was surgically evacuated and followed by long-term high-dose intravenous antibiotic therapy. The patient made a complete recovery. A sudden severe headache can be caused by an intracranial infection and intracranial pus collections can occur in the subdural as well as in the epidural space. Epidural empyema is a limited disease with relatively mild symptoms and a favourable prognosis, whereas subdural empyema may rapidly spread and cause severe disease with a poor prognosis. Quick antibiotic treatment and surgical drainage are required.
一名18岁既往健康的男性突然出现严重头痛，随后伴有恶心、呕吐、发热。在接下来的几周内出现了左侧偏瘫。脑部CT显示全鼻窦炎和额部硬膜外积脓。手术引流几天后，他的病情恶化，随后的CT显示右侧硬膜下积脓。对此进行了手术引流，随后进行了长期大剂量静脉抗生素治疗。患者完全康复。突发严重头痛可能由颅内感染引起，颅内积脓可发生在硬膜下以及硬膜外间隙。硬膜外积脓是一种局限性疾病，症状相对较轻，预后良好，而硬膜下积脓可能迅速扩散并导致严重疾病，预后较差。需要快速进行抗生素治疗和手术引流。
