gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Subdural empyema in children: therapeutic strategy: about five cases

Meeting Abstract

  • corresponding author O. Klein - Department of Neurosurgery, CHU Nancy
  • S. Freppel - Department of Neurosurgery, CHU Nancy
  • H. Schuhmacher - Department of infectious diseases, CHU Nancy
  • C. Pinelli - Department of Neurosurgery, CHU Nancy
  • J. Auque - Department of Neurosurgery, CHU Nancy
  • J.-C. Marchal - Department of Neurosurgery, CHU Nancy

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-01.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0004.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Klein et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The goal of this study is to determinate the accuracy of an “aggressive” surgical management of subdural empyemas (SDE) in children and young adults.

Methods

Four boys and one girl, aged from three month to 18 years at time of diagnosis (median age: 7 years) were admitted in our institution for SDE. SDE following intracranial surgery were excluded from the study. The data were reviewed retrospectively.

Results

All patients were treated surgically (burr hole evacuation or craniotomy, repeated in some cases), followed by intravenous antibiotherapy (mean time: 52 days) adapted to the micro-organism. Only the two patients treated by large craniotomy at first had a single surgical procedure. Involved micro-organisms are as follow: Streptococcus intermedius (N=2), Streptococcus Pneumoniae (N=1), Escherichia Coli (N=1), absence of any identified micro-organism (N=1). The five patients are alive (median follow-up: 22 month) without any sequelae.

Conclusions

We advocate an aggressive surgical treatment of SDE in children with a large bone flap to allow the surgeon to remove pus and membranes as much as possible, even in the interhemispheric fissure, followed by intravenous appropriate antibiotherapy and eradication of the source of infection. Even this “aggressive” treatment may sometimes not avoid re-operation. A careful follow-up is mandatory, because of the high risk of recurrence.