Pediatric parafalcine empyemas

Abstract

Subdural intracranial empyemas and brain abscesses are a rare complication of bacterial sinusitis. Pediatric parafalcine abscesses are a rare entity with different treatment compared with other brain abscesses. We present two pediatric cases with falcine abscess as a sinusitis complication and introduce our department’s treatment management. In addition a review of literature is performed. Surgical cases of our department and their management are compared with the current literature. In our cases, both of the children showed a recurrent empyema after the first surgical treatment and antibiotic therapy. A second surgical evacuation was necessary. The antibiotic therapy was given for 3 months. Short-time follow-up imaging is necessary irrespective of infection parameters in blood and patient's clinical condition. Especially in parafalcine abscesses a second look may be an option and surgical treatment with evacuation of pus is the treatment of choice if abscess remnants are visualized.

Rapidly developing subdural empyema in an adult with sinusitis: A neurosurgical threat alert

“…[3] Brief note Second surgery may be necessary. [7] Open craniotomy if the first surgery is burr hole evacuation Subdural effusions Depending on the symptoms, size, and mass effect surgical drainage may be necessary with or without placement of shunt tube…”

Gas-Forming Intracerebral Abscess with Pediatric Parafalcine Subdural Empyema with Review of Literature

“…35 Niklewski et al witnessed two cases of pediatric parafalcine empyemas as a complication of a sinusitis frontalis. 36 Parafalcine empyemas can present variably with symptoms being quite nonspecific like fever and headache or specif ic such as hemiparesis, impairment of consciousness, and seizures. Most of the pediatric brain abscesses generally present with headache (48%), fever (48%), nausea-vomiting (36%), and seizures (29.3%).…”