Subdural empyema lumbar puncture: Difference between revisions

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{{Subdural empyema}}
{{Subdural empyema}}
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{{CMG}} {{AE}} {{JS}}; {{AG}}


==Overview==
==Overview==
Subdural empyema, also referred to as [[subdural abscess]], [[pachymeningitis interna]] and [[circumscript meningitis]], is a life-threatening [[infection]].<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> It consists of a localised collection of [[pus|purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]] and accounts for about 15-22% of the reported focal intracranial [[infections]].  The [[empyema]] may develop intracranially (about 95%) or in the [[spinal canal]] (about 5%), and in both cases, it constitutes a [[medical emergency|medical]] and [[surgical emergency|neurosurgical emergency]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
Lumbar puncture is not diagnostic of subdural empyema. Lumbar puncture is an invasive procedure that is contraindicated in cases of suspected subdural empyema and [[increased intracranial pressure]], due to the risk of [[brain herniation]], and [[mortality]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
The [[Lumbar Puncture]] is an invasive procedure which is contraindicated in case of suspicion of subdural empyema and [[increased intracranial pressure]], due to risk of [[brain herniation]] and death.<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>


==Lumbar Puncture==
==Lumbar Puncture==
In'''infants''', in which subdural empyema is most commonly a complication of [[meningitis]], [[spinal fluid]] culture is the gold-stadard test for the diagnosis, therefore it should be used after ruling-out [[increased intracranial pressure]] <ref name="Hendaus2013">{{cite journal|last1=Hendaus|first1=Mohammed A.|title=Subdural Empyema in Children|journal=Global Journal of Health Science|volume=5|issue=6|year=2013|issn=1916-9744|doi=10.5539/gjhs.v5n6p54}}</ref>.
Lumbar puncture is not diagnostic of subdural empyema. Lumbar puncture is an invasive procedure that is contraindicated in cases of suspected subdural empyema and [[increased intracranial pressure]], due to the risk of [[brain herniation]], and [[mortality]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
 
In '''adults''', in which subdural empyema is most commonly a complication of [[sinusitis]], [[spinal fluid]] in normal circumstances is sterile, however, changes in [[white blood cell count]], [[glucose]] and [[protein]] concentrations are usually unspecific. Nevertheless, after increased intracranial pressure has been excluded, the [[lumbar puncture]] is a useful diagnostic test to rule out meningeal [[infection]]. <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref>
The CSF findings which may suggest an [[infection]] are:
*increased [[white blood cell count]]
*increased [[protein]] level
*decreased [[glucose]] levels
*occasionally [[CSF]] results may be normal and sterile


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Primary care]]
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[[Category:Emergency medicine]]
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[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Neurological disorders]]
[[Category:Neurological disorders]]
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Latest revision as of 00:20, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]

Overview

Lumbar puncture is not diagnostic of subdural empyema. Lumbar puncture is an invasive procedure that is contraindicated in cases of suspected subdural empyema and increased intracranial pressure, due to the risk of brain herniation, and mortality.[1]

Lumbar Puncture

Lumbar puncture is not diagnostic of subdural empyema. Lumbar puncture is an invasive procedure that is contraindicated in cases of suspected subdural empyema and increased intracranial pressure, due to the risk of brain herniation, and mortality.[1]

References

  1. ↑ 1.0 1.1 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.

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