[A case of interhemispheric subdural empyema with sinusitis diagnosed by diffusion-weighted MRI].
The patient was a 29-year-old man with sinusitis. He was admitted with high grade fever, headache, vomiting and disturbance of consciousness. Neurological examination revealed nuchal rigidity, aphasia, right hemiparesis, right sensory disturbance and bilateral Babinski signs. A nonenhanced CT on admission showed a low density area in the interhemispheric fissure. Gadolinium-enhanced MRI and DWI showed an interhemispheric subdural empyema and sinusitis. Neurological deficits gradually improved, after he underwent urgent surgical drainage of sinusitis followed by antibiotics therapy. About three weeks later, he developed right hemiparesis and disturbance of consciousness, and MRI demonstrated the expansion of interhemispheric subdural empyema. Therefore, he underwent surgical drainage of interhemispheric subdural empyema. He was discharged from our hospital without neurologic deficit. We suggest that MRI, in particular DWI, is a useful additional imaging modality for the diagnosis of interhemispheric subdural empyema.
Kawano
Hiroyuki
H
Department of Neurology, Kumamoto City Hospital.
Yonemura
Kiminobu
K
Misumi
Youhei
Y
Hashimoto
Yoichiro
Y
Hirano
Teruyuki
T
Uchino
Makoto
M
D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D004322:Drainage; D013354:Empyema, Subdural / Q000175:diagnosis* / Q000601:surgery; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012852:Sinusitis / Q000150:complications*
D019786:Gadolinium DTPA