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Intracranial Subdural Empyema in the era of Computed
Tomography: Review of 349 cases from the Neurosurgical Ward of Maputo Central
Hospital
Assane Y – Maputo, Mozambique
- Context Intracranial Subdural Empyemas (ISE) is the most common
form of infection observed in the Neurosurgical Ward of Maputo Central
Hospital (HCM). Not withstanding the modern anti-biotherapy advances in the
neurosurgical techniques and the availability of the neuro radiological
images, this clinic entity maintains its aggressive presence, leading to the
increase of morbidity and mortality.
- Objectives: This work intends to demonstrate the experience that
the Neurosurgical Ward of HCM acquired during the period of 1995 to 2004,
conducting cases of ISE in the era of Computed Tomography (CT).
- Methods A retrospective study was carried out involving all
patients with ISE, between January 1995 and December 2004. The criterion for
the inclusion of patients in the study was the identification of evident
purulent material in the subdural space. All patients with ISE where analyzed
for the clinic, radiological, bacteriologic, surgical and prognosis point of
view.
- Results The 349 cases of ISE represented 15% of all admissions by
intracranial sepsis during the study period. Male patients during their second
and their decades of living where the most affected (62%). Almost all patients
where submitted to surgery, representing a total of approximately 96%. Among
these, 82% had a good prognosis (in the Glasgow Scale of Prognosis of 4 or 5).
Mobility rate was of 25.9% (including situations of post-operation seizures).
Mortality rate was of 12.3% (43 patients).
- Conclusion ISE is a neurosurgical emergency rapidly fatal when not
detected at treated at early stage. Surgical drainage, primary focus
eradication and IV administration of high dosages of appropriate antibiotics
represent key issues in the treatment process.
- Form de Presentation The work of this abstract will be presented
through a PowerPoint Presentation, requiring data show and laptop.
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