title: Spontaneous tension pneumocephalus in a patient with subdural empyema.
abstract: We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A "gas-forming" organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.
authors.affiliation: Department of Neurosurgery, King Edward VII Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Dr. E Borges Marg, Parel, Mumbai 400012, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Redhu
authors.forename: Abhidha
authors.initials: A
authors.lastname: Shah
authors.forename: Madan
authors.initials: M
authors.lastname: Jadhav
authors.forename: Atul
authors.initials: A
authors.lastname: Goel
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology; D013354:Empyema, Subdural / Q000150:complications* / Q000209:etiology*; D004927:Escherichia coli Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011007:Pneumocephalus / Q000209:etiology*; D014057:Tomography, X-Ray Computed