alexa Parafalcine Subdural Empyema in a Woman with Recurrent Acute Otitis Media
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Parafalcine Subdural Empyema in a Woman with Recurrent Acute Otitis Media

Chang-Han Lo1, Chun-Chieh Lin2, Yuan-Hao Chen3, Giia Sheun Peng2 and Yueh-Feng Sung2*
1Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
2Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
3Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Corresponding Author : Yueh-Feng Sung
Address: No. 325, Section 2
Cheng- Gong Road, Neihu 114
Taipei, Taiwan, R.O.C.
Tel: +886 2 87923311-16875
Fax: +886 2 87927174
E-mail: [email protected]
Received June 25, 2014; Accepted August 22, 2014; Published August 25, 2014
Citation: Lo CH, Lin CC, Chen YH, Peng GS, Sung YF (2014) Parafalcine Subdural Empyema in a Woman with Recurrent Acute Otitis Media. J Clin Case Rep 4:399. doi:10.4172/2165-7920.1000399
Copyright: © 2014 Lo CH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Subdural empyema (SDE) most frequently arises as a complication of paranasal sinusitis and is a serious intracranial infection. Parafalcine SDE, resulting from acute otitis media, is a rare phenomenon. Here, we report the case of 57 year old woman, with a history of nasopharyngeal carcinoma (NPC) with radiotherapy, 28 years ago and recent diagnosis of recurrent acute otitis media, who was admitted to the emergency department with a 2 days history of progressive right-sided limb weakness. Neurological examination revealed right-sided hemiparesis without meningeal signs. Non-enhanced computed tomography (CT) scans of the brain revealed a hypodense lesion in the left parafalcine region. Gadolinium-enhanced magnetic resonance imaging demonstrated layers of rim-enhancing subdural fluid collection and swelling of the surrounding brain, suggestive of empyema. The patient underwent surgical evacuation of empyema and was treated with intravenous antibiotics for 6 weeks. The patient recovered well without neurological deficits. Follow-up brain CT 6 weeks later showed complete resolution of previous lesions. Acute otitis media complicated by SDE is a rare clinical phenomenon that carries a high mortality rate. The complication risk may be higher in NPC patients following radiotherapy. Early diagnosis of SDE and prompt surgical evacuation of purulent material can result in a full recovery.

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