Subdural empyema differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Subdural empyema, also referred to as subdural abscess, pachymeningitis interna and circumscript meningitis, is a life-threatening infection.[1] It consists of a localised collection of purulent material, usually unilateral, between the dura mater and the arachnoid mater and accounts for about 15-22% of the reported focal intracranial infections The empyema may develop intracranially (about 95%) or in the spinal canal (about 5%), and in both cases, it constitutes a medical and neurosurgical emergency.[2]
Differential Diagnosis
The clinical features presented by a patient with subdural empyema, such as: fever, headache, focal neurological signs, seizures and altered mental status, are common to other pathologic conditions: [1][3]
- Subdural hematoma - accumulation of blood in the subdural space, which frequently surges in the presence of trauma. It may cause an increase of intracranial pressure causing compression and damage of the brain. The acute form of this condition is considered a medical emergency.
- Brain abscess - an abscess in the brain caused by the inflammation and accumulation of infected material from local or remote infectious areas of the body. The infectious agent may also be introduced as a result of head trauma or neurological procedures.
- Bacterial meningitis
- Viral encephalitis
- Epidural abscess
- Cerebral thrombophlebitis
- Superior sagittal sinus thrombosis
- Acute disseminated encephalomyelitis
- Acute necrotising hemorrhagic leukoencephalopathy
- Focal embolic encephalomalacia due to bacterial endocarditis
References
- ↑ 1.0 1.1 Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
- ↑ Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.