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Delayed intracranial subdural empyema following burr hole drainage: Case series and literature review.

Abstract A subdural empyema (SDE) following burr hole drainage of a chronic subdural hematoma (CSDH) can be difficult to distinguish from a recurrence of the CSDH, especially when imaging data is limited to a computed tomography (CT) scan.
PMID
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Authors

Mayor MeshTerms

Drainage

Empyema, Subdural

Hematoma, Subdural, Chronic

Postoperative Complications

Keywords
Journal Title medicine
Publication Year Start




PMID- 29718890
OWN - NLM
STAT- MEDLINE
DCOM- 20180509
LR  - 20180509
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Delayed intracranial subdural empyema following burr hole drainage: Case series
      and literature review.
PG  - e0664
LID - 10.1097/MD.0000000000010664 [doi]
AB  - RATIONALE: A subdural empyema (SDE) following burr hole drainage of a chronic
      subdural hematoma (CSDH) can be difficult to distinguish from a recurrence of the
      CSDH, especially when imaging data is limited to a computed tomography (CT) scan.
      PATIENTS CONCERNS: All patients underwent burr hole drainage of the CSDH at
      first, and the appearance of the SDE occurred within one month. DIAGNOSES: A
      contrast-enhanced magnetic resonance imaging (MRI) scan, with diffusion-weighted 
      imaging (DWI), revealed both the SDE and diffuse meningitis in all patients.
      INTERVENTIONS: In Case 1, because the patient was very young, burr hole drainage 
      of the SDE, rather than craniotomy, was performed. However, subsequent craniotomy
      was required due to recurrence of the SDE. In Cases 2 and 3, an initial
      craniotomy was performed without burr hole drainage. OUTCOMES: Symptoms improved 
      for all patients, and each was discharged without any neurologic deficits or
      subsequent recurrence. LESSONS: Neurosurgeons should consider the possibility of 
      infection if recurrence of CSDH occurs within 1 month following drainage of a
      subdural hematoma. A contrast-enhanced MRI with DWI should be performed to
      differentiate SDE from CSDH. In addition, surgical evacuation of the empyema via 
      wide craniotomy is preferred to burr hole drainage.
FAU - Kim, You-Sub
AU  - Kim YS
AD  - Department of Neurosurgery, Chonnam National University Hospital and Medical
      School, Gwangju, Republic of Korea.
FAU - Joo, Sung-Pil
AU  - Joo SP
FAU - Song, Dong-Jun
AU  - Song DJ
FAU - Kim, Sung-Hyun
AU  - Kim SH
FAU - Kim, Tae-Sun
AU  - Kim TS
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Craniotomy/*methods
MH  - Diagnosis, Differential
MH  - Diffusion Magnetic Resonance Imaging/methods
MH  - Dimensional Measurement Accuracy
MH  - *Drainage/adverse effects/methods
MH  - *Empyema, Subdural/diagnosis/etiology/physiopathology/surgery
MH  - *Hematoma, Subdural, Chronic/diagnosis/surgery
MH  - Humans
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Complications/diagnosis/physiopathology/surgery
MH  - Subdural Space/*diagnostic imaging
MH  - Tomography, X-Ray Computed/methods
MH  - Treatment Outcome
EDAT- 2018/05/03 06:00
MHDA- 2018/05/10 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/10 06:00 [medline]
AID - 10.1097/MD.0000000000010664 [doi]
AID - 00005792-201805040-00058 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0664. doi: 10.1097/MD.0000000000010664.