Wetterling T, Schönle P W, Bardosi A, Holzgraefe M, Demierre B
Centre of Neurological Medicine and Radiology, University of Göttingen, Germany.
Neurochirurgia (Stuttg). 1987 Sep;30(5):149-51. doi: 10.1055/s-2008-1054084.
A case is presented in which the initial CT scan failed to demonstrate subdural suppuration over both convexities. Definitive CT finding of subdural empyema (SDE) was only positive at an advanced stage, when a bilateral subgaleal empyema also spread out. Because of the fulminant development of the subdural empyema and the delayed diagnosis, the outcome was fatal in spite of neurosurgical operation. Subdural empyema is a neurological and neurosurgical emergency. Early diagnosis is imperative, because the mortality is about 25-40% and the outcome depends upon the promptness of diagnosis and the appropriate operation. In the recent literature the value of computerised tomography for early detection of subdural empyema is controversial. Some reports failed to demonstrate any evidence of purulent subdural collection in CT scans while others were able to make an early diagnosis. This report presents a case which demonstrates the difficulties in making an early diagnosis of a subdural empyema by CT.
本文报告一例病例，最初的CT扫描未能显示双侧脑凸面的硬膜下积脓。硬膜下积脓（SDE）的明确CT表现仅在晚期呈阳性，此时双侧帽状腱膜下积脓也已扩散。由于硬膜下积脓发展迅猛且诊断延迟，尽管进行了神经外科手术，结果仍为致命。硬膜下积脓是一种神经科和神经外科急症。早期诊断至关重要，因为死亡率约为25% - 40%，而结果取决于诊断的及时性和适当的手术。在最近的文献中，计算机断层扫描对硬膜下积脓早期检测的价值存在争议。一些报告未能在CT扫描中显示任何脓性硬膜下积液的证据，而其他报告则能够做出早期诊断。本报告展示了一例通过CT早期诊断硬膜下积脓存在困难的病例。
