Document Detail


The treatment and outcome of postmeningitic subdural empyema in infants.
MedLine Citation:
PMID:  20593986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The management of subdural empyema (SDE) has been debated in the literature for decades. Craniotomy and bur hole drainage have been shown to achieve a favorable outcome. However, there is a lack of comparative data for these modes of management of SDE subsequent to meningitis in infants. METHODS: The authors conducted a retrospective review of 33 infants identified with SDE due to meningitis at the Department of Neurosurgery, Chang Gung Memorial Hospital between 2000 and 2006. Preoperative clinical presentation, duration of symptoms, radiological investigations, CSF data, and postoperative outcome were analyzed and compared between these 2 surgical groups. RESULTS: At diagnosis, there were no differences between the groups in age, weight, degree of consciousness, CSF analysis, or duration of fever. The outcome data showed no difference in the number of days until afebrile, number of days of postsurgical antibiotic treatment, neurological outcome, recurrence rate, or complication rate. There was only 1 death in the series. CONCLUSIONS: Subdural empyema due to meningitis in infants is unique with respect to the pathophysiology, presentation, and treatment of SDE. Early detection and removal of SDE provide a favorable outcome in both surgical intervention groups. Bur hole drainage is less invasive, and it is possible to expect a clinical outcome as good as with craniotomy in postmeningitic SDE.
Authors:
Zhuo-Hao Liu; Nan-Yu Chen; Po-Hsun Tu; Shih-Tseng Lee; Chieh-Tsai Wu
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  6     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-42     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Chang Gung Memorial College of Medicine, Hospital and Chang Gung University, Linkou, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Combined Modality Therapy
Craniotomy*
Empyema, Subdural / diagnosis*,  surgery*
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Meningitis, Bacterial / diagnosis*,  surgery*
Meningitis, Escherichia coli / diagnosis,  surgery
Meningitis, Haemophilus / diagnosis,  surgery
Meningitis, Pneumococcal / diagnosis,  surgery
Neurologic Examination
Retrospective Studies
Streptococcal Infections / diagnosis,  surgery
Streptococcus agalactiae
Tomography, X-Ray Computed
Trephining*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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