Subdural Empyema

Intracranial subdural empyema is a loculated pus collection in the intracranial subdural space, the area between the dura and arachnoid mater surrounding the brain. The condition was referred to as "subdural abscess," "cortical abscess," "purulent pachymeningitis," "phlegmonic meningitis," or "subdural suppuration" before 1943. Focal intracranial infections can be classified as a brain abscess, epidural abscess, or subdural empyema. If bacterial infections were to be taken into consideration, the spectrum of infections of the central nervous system would also include more generalized or diffuse infections like pyogenic meningitis or ventriculitis.

This activity focuses on intracranial subdural empyema. The subdural space is continuous and has no anatomic barrier. Thus, subdural empyemas can spread over the brain convexities between both cerebral hemispheres and, in some cases, to the opposite hemisphere or even the posterior fossa. The condition is considered a potentially dangerous but treatable entity. Intracranial subdural empyema can lead to severe symptoms, or even death, by direct brain compression and injury due to the skull being a confined cavity. Prompt diagnosis and adequate treatment can, in most cases, prevent these types of complications, resulting in better outcomes. History and physical examination should direct the clinician to the suspected diagnosis. Imaging techniques often reliably confirm the condition.