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  • Title: Spectrum of intracranial subdural empyemas in a series of 45 patients: current surgical options and outcome.
    Author: Tewari MK, Sharma RR, Shiv VK, Lad SD.
    Journal: Neurol India; 2004 Sep; 52(3):346-9. PubMed ID: 15472424.
    Abstract:
    BACKGROUND: The subject of subdural empyema (SDE) is reviewed on the basis of experience with 45 cases. METHODS: Records of 45 patients with SDE were analyzed. There were 35 males and 10 females in the series. The majority of the patients were either infants (22.2%) or in their second and third decade of life (37.8%). For supratentorial SDE, craniotomy was done in 5 cases (11.1%). In six cases (13.3%) two burr-holes and in the rest of the cases multiple burrholes were done to evacuate the empyema. Craniectomy was done in three cases (6.7%), of which two had posterior fossa SDE. All patients received appropriate preoperative and postoperative broad-spectrum antibiotics. RESULTS: There was good recovery in 35 (77.8%) patients, six patients (13.3%) had moderate disability, two patients (4.4%) had severe disability, and two (4.4%) died. Three patients who developed recollection at operation site required evacuation of residual SDE. Median follow-up was 3(1/2) years (range 4 months to 3(1/2) years). CONCLUSION: Emergent evacuation of SDE using multiple burr-holes and irrigation of the subdural cavity with saline for 24 hours results in a satisfactory outcome in cases with SDE.
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