438 results match your criteria Epidural and Subdural Infections


Neuroradiology of infectious diseases.

Curr Opin Infect Dis 2021 Jun;34(3):228-237

Section of Infectious Diseases, UT Health McGovern Medical School, Houston, Texas, USA.

Purpose Of Review: Early diagnosis of central nervous system (CNS) infections is crucial given high morbidity and mortality. Neuroimaging in CNS infections is widely used to aid in the diagnosis, treatment and to assess the response to antibiotic and neurosurgical interventions.

Recent Findings: The Infectious Diseases Society of America (IDSA) guidelines have clear recommendations for obtaining a computerized tomography of the head (CTH) prior to lumbar puncture (LP) in suspected meningitis. Read More

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Cerebral Microbleeds and Intracranial Hemorrhages in Adult Patients on Extracorporeal Membrane Oxygenation-Autopsy Study.

Crit Care Explor 2021 Mar 2;3(3):e0358. Epub 2021 Mar 2.

Department of Neurology, Johns Hopkins Hospital, Baltimore, MD.

Current studies lack robust information on the prevalence and associated factors of cerebral microbleeds in patients who underwent extracorporeal membrane oxygenation.

Design: Retrospective analysis.

Setting: We reviewed patients who underwent (extracorporeal membrane oxygenation) and subsequent brain autopsy with gross and microscopic examinations from January 2009 to December 2018 from a single tertiary center. Read More

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Hyperbaric oxygen for intracranial abscess.

Undersea Hyperb Med 2021 First Quarter;48(1):97-102

Departments of Anesthesiology and Medicine, Center for Hyperbaric Medicine and Environmental Physiology, Duke University, North Carolina U.S.

The term "intracranial abscess" (ICA) includes cerebral abscess, subdural empyema, and epidural empyema, which share many diagnostic and therapeutic similarities and, frequently, very similar etiologies. Infection may occur and spread from a contiguous infection such as sinusitis, otitis, mastoiditis, or dental infection; hematogenous seeding; or cranial trauma. In view of the high morbidity and mortality of ICA and the fact that hyperbaric oxygen therapy (HBO2) is relatively non-invasive and carries a low complication rate, the risk-benefit ratio favors adjunct use of HBO2 therapy in selected patients with intracranial abscess. Read More

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Towards improved outcome in children treated surgically for spontaneous intracranial suppuration in South Wales.

Br J Neurosurg 2021 Jan 11:1-4. Epub 2021 Jan 11.

Department of Paediatric Neurosurgery, University Hospital of Wales & Noah's Ark Children's Hospital, Cardiff, UK.

Introduction: Spontaneous central nervous system (CNS) infections in children are rare. Treatment involves surgical intervention and antibiotic therapy. We describe a single centre experience of managing this condition in South Wales. Read More

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January 2021

The Risk of Spread of Infection During Craniotomy/Craniostomy on Patients with Active Coronavirus Disease 2019 (COVID-19) Infection: Myth or Fact?

World Neurosurg 2021 03 14;147:e272-e274. Epub 2020 Dec 14.

Department of Neurosurgery, PGIMER, Chandigarh, India.

Objectives: Craniotomies/craniostomies have been categorized as aerosol-generating procedures and are presumed to spread coronavirus disease 2019 (COVID-19). However, the presence of severe acute respiratory distress syndrome coronavirus 2 virus in the generated bone dust has never been proved. Our objective is to evaluate the presence of virus in the bone dust (aerosol) generated during emergency neurosurgical procedures performed on patients with active COVID-19. Read More

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Advantages of using a prophylactic epidural closed drain and non-watertight dura suture in a craniotomy near the "parietal site".

Chin Neurosurg J 2020 5;6:34. Epub 2020 Oct 5.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070 China.

Background: In neurosurgery, the necessity of having a drainage tube is controversial. Subgaleal fluid collection (SFC) often occurs, especially in a craniotomy near the "parietal site".This study aimed to reassess the benefit of using a prophylactic epidural drainage (ED) and non-watertight dura suture in a craniotomy near the parietal site. Read More

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October 2020

Efficacy of high-dose versus low-dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial.

Trials 2020 Jul 29;21(1):685. Epub 2020 Jul 29.

Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Traumatic brain injury (TBI) is the most common trauma worldwide and is a leading cause of injury-related death and disability. Inflammation is initiated as a result of the TBI, which is in association with severity of illness and mortality in brain trauma patients, especially in subdural hemorrhage and epidural hemorrhage cases. A high percentage of adults admitted to the intensive care unit with TBI are diagnosed with vitamin D deficiency; this deficiency may induce impaired immune responses and increase the risk of infections. Read More

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[Acute mastoiditis with intracranial complication in a pediatric patient].

Arch Argent Pediatr 2020 04;118(2):e166-e169

Unidad de Infectología Pediátrica, Hospital Infantil Miguel Servet, Zaragoza, España.

Acute mastoiditis is an infection that affects the mastoid air-cell system, usually due to the progression of an acute otitis media. The bacteria most frequently isolated in acute mastoiditis are Streptococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus. The mastoid infection can extend affecting contiguous structures and producing intra or extracranial complications. Read More

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Treatment of CSF leakage and infections of dural substitute in decompressive craniectomy using fascia lata implants and related anatomopathological findings.

Br J Neurosurg 2021 Feb 6;35(1):18-21. Epub 2020 Mar 6.

Department of Neurosurgery, San Giovanni-Addolorata Hospital, Rome, Italy.

Purpose: Decompressive craniectomy (DC) is widely used to treat raised intracranial pressure (ICP) in cranial trauma and stroke. It is accompanied by numerous complications. The aim of our study is to assess the surgical treatment of infections related to the use of a dural substitute with concurrent CSF leakage performed at our institution. Read More

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February 2021

Neuronavigation-Guided Endoscopic Endonasal Drainage of Pediatric Anterior Cranial Base Epidural and Subdural Empyema.

Pediatr Neurosurg 2020 21;55(1):67-71. Epub 2020 Jan 21.

Pediatric Neurosurgery Service, Department of Surgery, Sainte-Justine University Hospital Center, Montreal University, Montreal, Québec, Canada,

In children, epidural and/or subdural intracranial empyema can complicate frontal sinusitis or pansinusitis. The standard transcranial approach used to treat epidural or subdural empyema has many drawbacks, but these can be avoided with an endoscopic expanded endonasal approach (EEA). To support the feasibility and advantages of this approach, we report the successful drainage through endoscopic EEA of a bifrontal empyema caused by an intracranial extension of pansinusitis. Read More

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November 2020

Intracranial complications of pediatric rhinosinusitis: Identifying risk factors and interventions affecting length of hospitalization.

Int J Pediatr Otorhinolaryngol 2020 Apr 19;131:109841. Epub 2019 Dec 19.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology-Head and Neck Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA.

Objective: To identify risk factors and interventions affecting length of hospitalization (LOH) and clinical outcome in children with intracranial complications of rhinosinusitis.

Methods: Retrospective chart review of 12 children hospitalized at 2 academic medical centers for intracranial complications of rhinosinusitis over the past 5 years.

Results: 12 patients were identified with an average age at presentation of 13 years old. Read More

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Spinal Epidural Hematoma Post Evacuation of Spontaneous Spinal Intradural Hematoma.

World Neurosurg 2020 Mar 28;135:160-164. Epub 2019 Nov 28.

Department of Spine Service, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India.

Background: Spinal hematomas are rarely associated with dengue syndrome and usually occur at the time of active dengue fever. Late presentation after recovery from dengue fever, intradural hematoma, presentation as a multiloculated cystic lesion with longitudinal extensive myelitis, and recurrence after surgery are rarely or not described. Due to the peculiar association of all these findings, we report this case to provide insight into the existence of such a rare presentation. Read More

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Complications of Otitis Media and Sinusitis Caused by Streptococcus anginosus Group Organisms in Children.

Pediatr Infect Dis J 2020 02;39(2):108-113

From the Department of Pediatrics, Section of Infectious Diseases.

Background: The Streptococcus anginosus group (SAG, S. anginosus, S. intermedius and S. Read More

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February 2020

Successful surgical management of an Escherichia coli epidural-subdural abscess secondary to sino-rhinotomy.

J Vet Emerg Crit Care (San Antonio) 2019 Nov 22;29(6):696-701. Epub 2019 Oct 22.

Small Animal Teaching Hospital, University of Liverpool, Neston, UK.

Objective: To describe a case of successful management of epidural-subdural abscess and severe meningitis with secondary brain herniation in a dog.

Case Summary: A rhino-sinusotomy was performed in a 3-year-old mixed-breed dog for management of refractory sinonasal aspergillosis. Initial recovery was good, but the dog became acutely stuporous 36 hours after surgery. Read More

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November 2019

Intracranial subdural empyemas and epidural abscesses in children

J Neurosurg Pediatr 2019 07 22;24(1):14-21. Epub 2019 Mar 22.

1Department of Neurological Surgery, University of Kansas, Kansas City, Kansas; and.

Objective: The authors conducted a retrospective analysis of a consecutive series of children with intracranial subdural empyemas (SEs) and epidural abscesses (EAs) to highlight the important clinical difference between these two entities. They describe the delays and pitfalls in achieving accurate diagnoses and make treatment recommendations based on clinical and imaging findings.

Methods: They reviewed their experience with children who had presented with intracranial SE and/or EA in the period from January 2013 to May 2018. Read More

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Dural Reconstruction Using Laparoscopic Gastro-omental Free Flap in Refractory Cranial Infections.

Ann Plast Surg 2020 01;84(1):62-67

Departments of Plastic and Reconstructive Surgery.

Background: Epidural abscesses and subdural empyema after craniotomy are potentially lethal complications in neurosurgery. Patients with recalcitrant cranial wound infections may be difficult to manage, and dural reconstruction in these patients is challenging.

Methods: A total of 14 patients presented with recurrent intracranial infection after craniotomy. Read More

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January 2020

Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following transarticular screw fixation with posterior wiring for atlantoaxial instability: A case report.

Medicine (Baltimore) 2019 Jul;98(28):e14847

Department of Neurosurgery, Baylor College of Medicine, TX.

Rationale: Atlantoaxial transarticular screw fixation has been an effective and appealing method for inducing fusion of the C1-C2 complex. This technique is usually performed with Gallie fusion. In performing Gallie fusion using sublaminar wiring, a major concern is the risk of dural tear associated with passing sublaminar wires through the epidural space. Read More

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HIV, Tuberculosis, and Otogenic Intracranial Sepsis: A Devastating Disease With a Subtle Presentation.

Otol Neurotol 2019 08;40(7):e704-e712

Department of Ear, Nose, and Throat, NHS Foundation Trust, University Hospitals of Leicester, Leicester, UK.

Objectives: To undertake a large-scale review of otogenic intracranial sepsis in an area of highly prevalent HIV and tuberculosis (TB) to re-examine and inform early diagnosis and treatment efforts.

Methods: Seventy-seven consecutive cases of otogenic intracranial sepsis in KwaZulu-Natal, South Africa were reviewed for demographics, presentation, imaging, HIV status, culture results, and outcomes.

Results: The most common intracranial complications were intracranial abscess (46. Read More

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Clinical Features of Patients With Spontaneous Intracranial Hypotension Complicated With Bilateral Subdural Fluid Collections.

Headache 2019 05 15;59(5):775-786. Epub 2019 Apr 15.

Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Background: Subdural hygromas are often found bilaterally in spontaneous intracranial hypotension (SIH). They frequently progress to chronic subdural hematomas (CSDHs), and if the hematomas are formed, it is difficult to consider SIH as an underlying cause. Whether SIH is underlying or not among the patients presenting bilateral subdural fluid collections (hygromas or CSDHs) is clinically important because the treatment strategy should be different between them. Read More

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Mutation in Gene Can Cause Syndromic Multisystem Autoimmune Disease With Acute Liver Failure.

Pediatrics 2019 02;143(2)

Departments of Pediatrics, Gastroenterology, and Hepatology and

Pediatric intractable autoimmune hepatitis is rare and may be responsible for acute liver failure. Mutations in the itchy E3 ubiquitin protein ligase () gene (located on chromosome 20q11.22) can lead to a deficiency of the encoded protein, resulting in increased T-cell activity with lack of immune tolerance and manifestation of a complex systemic autoimmune disease. Read More

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February 2019

Primary Care for Persons Who Inject Drugs.

Am Fam Physician 2019 01;99(2):109-116

University of Maryland School of Medicine, Baltimore, MD, USA.

More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, neurologic, and other causes of morbidity and mortality. Nonjudgmental inquiries about current drug use can uncover information about readiness for addiction treatment and identify modifiable risk factors for complications of injection drug use. Read More

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January 2019

The interhemispheric approach in children: our experience and review of the literature.

Childs Nerv Syst 2019 03 7;35(3):445-452. Epub 2019 Jan 7.

Departments of Neurosurgery and Pediatric Neurosurgery, Tel-Aviv Sourasky Medical Center and Dana Children's Hospital Tel Aviv, Tel Aviv University, 6 Weizmann Street, Tel Aviv, Israel.

Objective: The interhemispheric approach (IA) has been extensively described for treating pathologies located at the lateral or third ventricle, pineal region, and periventricular locations. While these anatomical locations are the target of many pediatric pathologies, very few series have analyzed the morbidity and outcome of the IA in children. The aim of this study is to describe our experience using the IA in children, emphasizing the approach-related morbidity. Read More

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Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis.

BMC Infect Dis 2018 Dec 20;18(1):686. Epub 2018 Dec 20.

Semmelweis University, Institute of Medical Microbiology, Budapest, Hungary.

Background: Central nervous system (CNS) infections caused by Actinomyces spp. including brain abscess, actinomycoma, subdural empyema and epidural abscess are well described, however reports of Actinomyces-associated meningitis are scarcely reported.

Case Report: We present the case of a 43-year-old Hungarian male patient with poor socioeconomic status who developed acute bacterial meningitis caused by Actinomyces turicensis originating from the left side mastoiditis. Read More

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December 2018

T2-blackout effect on DWI as a sign of early bone infarct and sequestration in a patient with sickle cell disease.

Clin Imaging 2019 Mar - Apr;54:15-20. Epub 2018 Nov 15.

Department of Radiology, University of Florida, Gainesville, FL, United States of America.

Differentiation of bone infarct from osteomyelitis is one of the most challenging issues in the evaluation of acute bone pain in sickle cell patients. The imaging modalities that are currently being used for assessment of bone marrow in this population have several limitations. We present a case of an 18-year-old male with a history of sickle cell disease, who was transferred to our emergency department with progressively severe headache and jaw pain for one-week. Read More

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Long-Term Follow-Up of a Patient with Spondylodiscitis after Laparoscopic Sacrocolpopexy: An Unusual Complication with a Review of the Literature.

Urol Int 2019 28;103(3):364-368. Epub 2018 Nov 28.

Department of Obstetrics and Gynecology, Division of Urogynecology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

Sacrocolpopexy is the gold standard treatment for apical compartment prolapse with reported success rates of 78-100%. Spondylodiscitis is a rare complication of sacrocolpopexy and includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. Here we report a case of spondylodiscitis following laparoscopic sacrocolpopexy with long-term follow-up and discuss management of spondylodiscitis after abdominal sacrocolpopexy, with a review of the literature. Read More

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February 2020

Dengue Fever Presenting with Cervicodorsal Acute Spinal Spontaneous Subdural Hematoma-Case Report and Review of Literature.

World Neurosurg 2019 Feb 4;122:272-277. Epub 2018 Nov 4.

Department of Neurosurgery, Institute of Neurosciences, Medanta the Medicity, Gurgaon, Haryana, India.

Background: Neurologic complications are increasingly being reported in dengue epidemics. Intraspinal hematomas are rare, and those associated with dengue fever are still rarer with only 1 being reported in the literature.

Case Description: We report a case of dengue fever presenting with acute-onset quadriparesis (upper limbs Medical Research Council [MRC] 4/5 and lower limbs 0/5) and urinary incontinence. Read More

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February 2019

Concurrent Intramedullary and Intracranial Tuberculomass.

J Assoc Physicians India 2018 04;66(4):72-4

Senior Resident Neurosurgery, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh.

Tuberculosis of the central nervous system (CNS) is well known. CNS involvement can occur in the form of tubercular meningitis (TBM), tuberculous vasculitis, tuberculoma and rarely brain abscess. Tubercular granulomas generally solitary and occur in the brain but they may be multiple and involve other areas such as spinal cord, epidural space and subdural space also. Read More

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Intensive care resources required to care for critically ill children with focal intracranial infections.

J Neurosurg Pediatr 2018 10 13;22(4):453-461. Epub 2018 Jul 13.

1Division of Critical Care Medicine, Nationwide Children's Hospital.

The authors reviewed cases in which children with a focal infection inside the head (ex: a brain abscess) were cared for in their pediatric ICU to describe the frequency of complications and quantify the ICU resources needed (ex: breathing tube, blood pressure medications, and/or an intracranial pressure monitor). This information helps clarify illness severity and has identified complications that we should further investigate to improve care for these children. Read More

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October 2018