Traumatic cranial empyemas: a review of 55 patients

A 15-year (1983-1997) review of our unit's computed tomographic experience with traumatic cranial empyema (TCE) is reported. Fifty-five patients with documented history and clinical evidence of neurotrauma with secondary cranial empyema at surgery were identified. The clinical records and CT sc...

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Bibliographic Details
Published in:British journal of neurosurgery 2000-08, Vol.14 (4), p.326-330
Main Author: Nathoo, S. S. Nadvi, J. R. Van Dellen, N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Cranial Depressed Fracture Empyema Trauma
Empyema, Subdural - diagnosis
Empyema, Subdural - etiology
Empyema, Subdural - surgery
Female
Fractures
Humans
Infections
Injuries of the nervous system and the skull. Diseases due to physical agents
Male
Medical sciences
Middle Aged
Neurology
Retrospective Studies
Skull Fracture, Depressed - complications
Skull Fracture, Depressed - diagnostic imaging
Survival Rate
Tomography
Tomography, X-Ray Computed
Traumas. Diseases due to physical agents
Treatment Outcome
Tropical medicine
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Summary:A 15-year (1983-1997) review of our unit's computed tomographic experience with traumatic cranial empyema (TCE) is reported. Fifty-five patients with documented history and clinical evidence of neurotrauma with secondary cranial empyema at surgery were identified. The clinical records and CT scans were analysed. TCE [four extradural and 51 subdural collections (SDE)] accounted for 7.86% of the total cranial empyemas seen during the study period. Most of the patients were young males (44 patients) and neurological deficits on admission were found only in the SDE group. Forty-one of 53 patients presented with septic compound skull fractures. Fifty-four patients had urgent surgical drainage. Eighty per cent of patients experienced a good outcome (GOS 4 or 5). A morbidity of 16.4% (including postoperative seizures) was noted and eight patients died (mortality rate 14.5%). Urgent surgical drainage, removal of osteitic bone, wound debridement and high dose intravenous antibiotic therapy form the mainstay of treatment.
ISSN:0268-8697
1360-046X
DOI:10.1080/026886900417306