Subdural empyema

Case contributed by Dr Ammar Haouimi

Presentation

Treated for a pyogenic meningitis (Escherichia coli) with no significant improvement, presented with fever and irritability.

Patient Data

Age: 2 months
Gender: Female
MRI

MRI demonstrates bilateral crescent-shaped subdural collections more marked on the left with interhemispheric extension. They appear of low signal on T1 and FLAIR (the signal is slightly higher than that of the CSF), high signal on T2 with marginal enhancement. No mass effect on the midline structures. The cerebral venous sinuses are patent.

Case Discussion

 Subdural empyema is defined as an infection of the subdural space, often seen as a complication of meningitis in the pediatric population. Other etiologies include; sinusitis, otitis, mastoiditis; trauma or surgical intervention.

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