Sinugenic epidural empyema
Bilateral otitis media not responding to antibiotics
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- Complete opacification of both mastoid air cells with rarefaction and bone defect seen at the lateral wall of the left mastoid bone associated with subcutaneous ring enhancing fluid collection seen adjacent to the left mastoid bone defect.
- Evidence of small epidural, limited by squamous suture, lentiform in shape, hypodense fluid collection with peripheral enhancement in the left temporal lobe at the same level of the left temporal subcutaneous abscess. However the separated bone appears to be intact apart from subtle thinning.
- No abnormal post contrast meningeal or dural enhancement.
Diagnosing an epidural abscess is important as may progress to meningitis, cerebritis or cortical venous thrombosis.
- Appliedradiology.com. (2018). Imaging of intracranial infectious diseases in adults. [online] Available at: https://appliedradiology.com/articles/imaging-of-intracranial-infectious-diseases-in-adults [Accessed 29 Nov. 2018].
- Handel, SF, Klein, WC, Kim, YW. Intracranial epidural abscess. Radiology. 1974;111:117–120.
- Pradilla G, Ardila GP, Hsu W, Rigamonti D. Epidural abscesses of the CNS. Lancet Neurol 2009; 8:292