Eça Rosário, Graça Armando, Francisco Rita, Pamplona Jaime
Internal Medicine, Centro Hospitalar de Lisboa Central, Lisboa, PRT.
Critical Care, Centro Hospitalar de Lisboa Central, Lisboa, PRT.
Cureus. 2024 Jan 30;16(1):e53249. doi: 10.7759/cureus.53249. eCollection 2024 Jan.
Subdural empyema (SDE) is a rare form of intracranial infection associated with a high morbidity and mortality rate. Infections of the middle ear and paranasal sinuses are the most common predisposing factors that can lead to bacterial proliferation in the subdural space, usually by direct extension in young patients. Clinicians must have a high level of suspicion for patients presenting with concomitant neurological deficits and signs of sinus pathology. Cross-sectional imaging is mandatory for the diagnosis, preferably contrast-enhanced magnetic resonance imaging. Treatment requires a prolonged course of intravenous antibiotherapy and prompt neurosurgical drainage intervention. Here, we present the case of a 20-year-old patient with long-term neurological sequelae following a left paranasal infection complicated by an SDE. This case report highlights the rapid progression and devastating consequences of SDE, an ominous neurosurgical emergency.
硬脑膜下积脓（SDE）是一种罕见的颅内感染形式，发病率和死亡率都很高。中耳和鼻窦感染是最常见的诱发因素，通常在年轻患者中通过直接蔓延导致细菌在硬脑膜下间隙增殖。对于伴有神经功能缺损和鼻窦病变体征的患者，临床医生必须高度怀疑。诊断必须进行横断面成像，最好是增强磁共振成像。治疗需要长时间的静脉抗生素治疗，并及时进行神经外科引流干预。在此，我们报告一例20岁患者，其左侧鼻窦感染并发SDE后出现长期神经后遗症。本病例报告强调了SDE的快速进展和严重后果，这是一种凶险的神经外科急症。
