Brain Infection After Cesarean Section: A Case of Subdural Empyema Post-Cesarean Section

Abstract

We report a rare case of parieto-frontal subdural empyema after a cesarean section. A 23-year-old woman with a history of cesarean section, two weeks prior to admission, presented to the emergency room with the chief complaint of a headache, fever (39.5°C), nausea, vomiting, aphasia, tonic colonic movement, and a Glasgow coma scale score of 10/15 two weeks after a cesarean section. A subdural fluid collection in parieto-frontal on the left side was demonstrated in the brain MRI. She received rapidly an anticonvulsant drug (diazepam) and empirical board-spectrum antibiotics (vancomycin, metronidazole, and ceftriaxone) and subsequently underwent an urgent craniotomy. Antibiotic therapy continued for 4 weeks, the patient symptoms and signs improved, and she was discharged with a Glasgow coma scale score of 15/15 without neurological deficit and seizure.

A Review of Bispectral Index Utility in Neurocritical Care Patients

“…The study of BIS values and the ischemic-hypoxic brain injury has had conflicting results. Some have shown the positive correlation of the BIS values to the extent of ischemic-hypoxic brain injury, especially in the frontal region, and demonstrated a sudden drop in these values to be associated with cerebral hypo-perfusion (60)(61)(62)(63)(64)(65). Some studies did not support these observations (66).…”