Giant subdural empyema in a child: a case report.
An unusual case of a giant (8 x 6 x 6 cm) frontoparietal SDE of Streptococcus pneumoniae in a 17-month-old child is reported. The initial diagnosis was made with emergency CT. The purulent material was removed via a frontoparietal craniotomy. A series of postoperative MR imaging showed the gradual reduction in size of the lesion, although collapsed capsule, fibrous thickening of meningeal structures and associated displacement of the underlying brain persisted. The child was symptom-free in a follow-up period of 15 months. This case showed that SDE may reach a giant size and thus may mimic an intra-axial lesion; the coronal MR imaging is a more reliable diagnostic tool than the emergency axial CT in giant SDE of upper convexity localization, and the clinical improvement may be more impressive than the radiological changes.
Hicdonmez
Tufan
T
Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne 22030, Turkey. tufanhicdonmez@yahoo.com
Cakir
Bilge
B
Hamamcioglu
M Kemal
MK
Kilincer
Cumhur
C
Cobanoglu
Sebahattin
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003399:Craniotomy; D004359:Drug Therapy, Combination; D013354:Empyema, Subdural / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007223:Infant; D008279:Magnetic Resonance Imaging; D010296:Parietal Lobe / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D015378:Imipenem