The underlying causes and management of intracranial subdural empyema in the neurosurgery department, Chris Hani Baragwanath Academic Hospital

Abstract

Intracranial subdural empyema (SDE) is a potentially life-threatening condition. A retrospective study of the Chris Hani Baragwanath Academic Hospital’s neurosurgery unit’s SDE patients revealed a mean age of presentation of 15 years and male predominance (70%). In 61.7% SDE was linked with sinusitis and in 83% with immunocompetence. There was a statistically significant correlation between immunocompromise and death (40% mortality rate in the immunocompromised subset). Among the patients’ culture positive specimen, 57.1% yielded a Streptococcus spp., gram negative isolates were found in patients with immunocompromise or previous head trauma/surgery, and 78.6% of the micro-organisms were sensitive to 3rd generation cephalosporins. There was an 86.7% survival rate. A determinant of residual neurological deficit could not be found among the parameters investigated.

Keywords: intracranial subdural empyema, complicated sinusitis, burrholes