Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
J Med Case Rep. 2020 Jul 11;14(1):95. doi: 10.1186/s13256-020-02429-2.
Chronic calcified subdural empyema is an exceedingly rare central nervous system infection with a handful of cases published to date. Reported cases presented with nonspecific clinical signs and symptoms. The duration between the initial onset of symptoms and diagnosis can vary drastically from a few years to up to 46 years. Although there are known predisposing causes, the initial source of infection can sometimes be difficult to identify.
Our patient was a 39-year-old Ethiopian man who presented with left-side body weakness of 6 years' duration with worsening of symptoms of 6 months' duration. He had no history of trauma, meningitis, or previous surgery. The results of routine laboratory tests were normal. The diagnosis was made by computed tomography and magnetic resonance imaging and was confirmed by surgery. Frontoparietal craniotomy was performed, and evacuation of non-foul-smelling collection was done. The patient was reoperated for tension pneumocephalus 48 hours after the initial surgery. He died 10 days later.
This is a rare case of a giant chronic calcified subdural empyema with no known preceding history of trauma or infection.
慢性钙化性硬脑膜下脓胸是一种极为罕见的中枢神经系统感染，迄今为止仅有少数病例报道。已报道的病例表现出非特异性的临床症状和体征。从最初出现症状到确诊的时间间隔差异很大，从数年到长达 46 年不等。尽管存在已知的诱发因素，但感染的初始来源有时难以确定。
我们的患者是一名 39 岁的埃塞俄比亚男性，左侧身体无力 6 年，症状加重 6 个月。他无外伤、脑膜炎或既往手术史。常规实验室检查结果正常。通过计算机断层扫描和磁共振成像做出诊断，并通过手术得到证实。行额顶颅骨切开术，清除无恶臭的积液。初次手术后 48 小时，患者因张力性气颅再次手术。10 天后，他死亡。
这是一例罕见的巨大慢性钙化性硬脑膜下脓胸病例，无已知的先前创伤或感染史。
