Subdural empyema - Revision history

ClaireLewis: /* Evaluation */

2019-10-02T22:45:46Z

Evaluation

← Older revision		Revision as of 22:45, 2 October 2019
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	==Evaluation==		==Evaluation==
	*Assess for alternative causes of symptoms (e.g. labs to rule out metabolic process, glucose, infectious workup)		*Assess for alternative causes of symptoms (e.g. labs to rule out metabolic process, glucose, infectious workup)
	*[[MRI brain]] with contrast		*[[brain MRI\|MRI brain]] with contrast
	*Blood cultures		*Blood cultures
	*Definitive diagnosis by culture of surgical specimens		*Definitive diagnosis by culture of surgical specimens

ClaireLewis: /* Evaluation */

2019-10-02T22:45:32Z

Evaluation

← Older revision		Revision as of 22:45, 2 October 2019
Line 27:		Line 27:
	==Evaluation==		==Evaluation==
	*Assess for alternative causes of symptoms (e.g. labs to rule out metabolic process, glucose, infectious workup)		*Assess for alternative causes of symptoms (e.g. labs to rule out metabolic process, glucose, infectious workup)
	*MRI brain with contrast		*[[MRI brain]] with contrast
	*Blood cultures		*Blood cultures
	*Definitive diagnosis by culture of surgical specimens		*Definitive diagnosis by culture of surgical specimens

ClaireLewis: Created page with "==Background== *Usually complications of sinusitis (especially frontal, ethmoidal, or sphenoidal) or otitis media **Other causes include other ear infections, head t..."

2019-08-26T01:53:43Z

Created page with "==Background== *Usually complications of sinusitis (especially frontal, ethmoidal, or sphenoidal) or otitis media **Other causes include other ear infections, head t..."

New page

==Background==
*Usually complications of [[sinusitis]] (especially frontal, ethmoidal, or sphenoidal) or [[otitis media]]
**Other causes include other ear infections, [[head trauma|cranial trauma]] or surgery, or rarely [[bacteremia]]
**In children <5yo, cause is typically bacterial meningitis
*Typically due to epidural abscess extending into subdural space to cause subdural empyema

==Clinical Features==
*[[Fever]]
*[[Headache]]
*[[Lethargy]]
*[[Focal neuro deficits]], particularly with rapidly developing neuro deficits suggesting involvement of entire hemisphere
*[[Seizures]]
*Complications
**[[Meningitis]]
**Cortical venous thrombosis
**[[Brain abscess]]

==Differential Diagnosis==
*[[CVA]]
*[[Meningitis]], [[encephalitis]]
*Malignancy

{{Intracranial mass DDX}}

==Evaluation==
*Assess for alternative causes of symptoms (e.g. labs to rule out metabolic process, glucose, infectious workup)
*MRI brain with contrast
*Blood cultures
*Definitive diagnosis by culture of surgical specimens
*[[LP]] ''NOT'' helpful and may precipitate herniation
*In infants, a subdural tap may be diagnostic and may relieve pressure

==Management==
*Address airway protection
*Antibiotics similar to those used for brain abscess: e.g. [[cefotaxime]], [[ceftriaxone]], [[metronidazole]], [[vancomycin]]
**In children, cover also for bacterial meningitis
*Emergent neurosurgery consult for drainage

==Disposition==
*Admit

==See Also==

==External Links==

==References==
<references/>
[[Category:ID]] [[Category:Neurology]]