title: Aspiration of parafalcine empyemas with flexible scope.
abstract: OBJECTIVE
  Subdural empyemas are considered neurosurgical emergencies, and the parafalcine location is particularly insidious. We revised the experience of general surgeons who are used to manage chronic pleural purulent collections with video-assisted thoracoscopy.
  
  
  METHODS
  With a similar technique, we successfully aspirated a parafalcine empyema using a flexible scope avoiding a more invasive craniotomy. A review of the treatment options of empyematous collections is also provided, focusing particularly on the hazardous parafalcine location.
  
  
  RESULTS
  The management of subdural empyemas poses different decision-making problems compared to common brain abscesses, urging a more rapid and holistic surgical treatment with minimally invasive approach. Endoscopic aspiration of parafalcine empyema was followed by complete recovery in our patient.
  
  
  CONCLUSIONS
  Flexible endoscopy is a promising method to obtain complete pus removal even from loculated collections through a bur hole, avoiding large craniotomies and consequent potential complications.
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sammartino
authors.affiliation: Neurosurgery Unit, Department of Neurosciences, NOCSAE Modena Hospital, Via Giardini 1355, 41126 Baggiovara, Modena, Italy. alberto.feletti@gmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Feletti
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fiorindi
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy.
authors.forename: Grazia Marina
authors.initials: GM
authors.lastname: Mazzucco
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Longatti
mesh_terms: D000293:Adolescent; D003399:Craniotomy / Q000379:methods; D004322:Drainage / Q000379:methods*; D013354:Empyema, Subdural / Q000000981:diagnostic imaging / Q000601:surgery*; D019723:Endoscopes; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
keywords: Empyema; Flexible scope; Neuroendoscopy; Parafalcine; Subdural empyema