Subdural empyema secondary to sinus infection in children.
OBJECTIVE
To evaluate the impact, on morbidity and mortality, of aggressive surgical management of subdural empyema of sinus origin in children.


METHODS
The authors conducted a retrospective review of 20 children admitted between 2000-2007 to Alder Hay Children Hospital and The Walton centre for Neurology and Neurosurgery for subdural empyema secondary to sinus infection. Clinical presentation, duration of symptoms, radiological investigations, surgical treatment and post-operative outcome were evaluated.


RESULTS
Outcome was favourable in 19 cases. In four cases, there were re-accumulation requiring surgical evacuation, four patients experienced post-operative seizures but were seizure-free at follow-up. There was only one mortality in the series.


CONCLUSIONS
Subdural empyema secondary to sinus infection, although uncommon, it could be associated with a relative high morbidity and mortality rate. Early aggressive surgical and medical management with drainage of intracranial or sinus collections and antibiotics therapy lead to a low mortality or morbidity rate and good clinical outcome.
Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. jibril@doctors.net.uk
Jibril
J
Osman Farah
Jothy
J
Kandasamy
Paul
P
May
Neil
N
Buxton
Conor
C
Mallucci
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications*; D002648:Child; D004322:Drainage / Q000379:methods; D013354:Empyema, Subdural / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications*; D013290:Streptococcal Infections / Q000150:complications; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents