Subdural abscess: causes, symptoms, diagnosis, treatment

Subdural abscess is an accumulation of pus under the dura mater of the brain.

Pathogenesis of subdural abscess

Subural abscess develops as a complication of chronic purulent otitis media, especially cholesteatom, much less often acute. It is localized in the middle or posterior cranial fossa. In the posterior cranial fossa, an abscess usually occurs with a purulent labyrinth or with thrombosis of the sigmoid sinus.

Diagnosis of subdural abscess

Physical examination

The proximity of the subdural abscess to the mild cerebral casing and the brain substance leads to the development of two groups of symptoms: meningeal and focal, corresponding to the localization of the abscess. When localized in the middle cranial fossa, focal symptoms can be in the form of light pyramidal signs on the opposite side. When localized in the posterior cranial fossa, there are cerebellar symptoms (nystagmus, a miss in the palcenosal test). The remitting course of the meningeal syndrome is characteristic of the subdural abscess. It is also possible to have cerebral symptoms. It should be remembered about the possibility of a latent, asymptomatic course of the subdural abscess.

Laboratory research

At subdural abscess there is a moderate pleocytosis of cerebrospinal fluid (up to 200-300 cells / μl).

Differential diagnostics

Differential diagnosis is performed with an intracerebral abscess. With severe cerebral symptoms, differential diagnosis with intracerebral abscess in the preoperative period becomes difficult.

[1], [2], [3], [4], [5], [6], [7]