Postoperative epilepsy in subdural suppurations

Calliauw, L.; Praetere, P. de; Verbeke, L.

doi:10.1007/bf01401316

Cited by 20 publications

(5 citation statements)

References 4 publications

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“…Paranasal sinus infections were the most common cause of subdural empyema (59%). The category miscellaneous includes among others local osteomyelitis of the skull, infections of the lungs and skin (paronychium and panaritium) and three cases 12 (12%) 9 (9%) 6 (6%) 15 (table 3). Nearly half of the patients had a severe disturbance of consciousness (stuporose 22% and comatose 24% (table 4)).…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the outcome in subdural empyema.

Mauser¹,

Houwelingen²,

Tulleken³

1987

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY The case reports of 102 patients with subdural empyema, diagnosed in the years 1935-83, were reviewed to determine the factors affecting the outcome. Statistical analysis (likelihood ratio tests with chi square approximation and logistic regression) showed that year of diagnosis (p < 0.01) and level of consciousness at the moment of diagnosis (p < 0 01) had a significant bearing on the chance to survive and that these same two factors (each factor p < 0O01) and extent of subdural pus accumulation at the moment of diagnosis (p < 0-05) had a significant bearing on the chance of survival without severe disability. Among others the duration of the disease up to the moment of diagnosis and the mode of the first surgical procedure had no significant bearing on the outcome. These results together with those in the literature are discussed and it is concluded that diagnosis and treatment before the patient lapses into stupor or coma, increases the chance of survival and that with adequate management a mortality rate of 10% or lower is to be expected.Subdural empyema is a rare intracranial infection with high mortality. A review in 1975 indicated a mortality rate of about 40%.1 In more recent series the mortality rate ranged from 12% to 29%.2 11 Bannister in 1981 stated that a mortality rate of about 10% is to be expected nowadays with early diagnosis and prompt treatment. He also stressed the importance of performing a craniotomy as the primary surgical procedure.4 To determine which factors affect the outcome 102 cases of subdural empyema, in which the diagnosis was established in the years 1935-83, were reviewed. Patients and methodsFrom the files of five neurosurgical centres in the Netherlands 102 patients were collected, in whom a subdural empyema was diagnosed between 1935 and 1983. In 97 cases the diagnosis was confirmed at operation. In four patients the diagnosis was made at necropsy and in one patient, who was treated non-surgically, CT confirmed the clinical diagnosis. The clinical findings of the patients have been reported in detail elsewhere. 11The outcome for each patient, mentioned in the clinical or outpatient chart, was graded according to a scale that was designed for this study (table 7). Grade A comprises patients who survived without or with a minor, not disabling, focal

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Section: Resultsmentioning

confidence: 99%

Factors affecting the outcome in subdural empyema.

Mauser¹,

Houwelingen²,

Tulleken³

1987

Journal of Neurology, Neurosurgery & Psychiatry

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“…Despite 101 patient-years of followup, only one new brain abscess occurred, which would suggest that the combination of antibiotic prophylaxis for bacteremic procedures and occlusion of the larger AVMs is effective in preventing brain abscess. Since brain abscess has a mortality of up to 24%, [32][33][34][35] this is an important event to prevent. Neurologic complications, rather than pulmonary complications, are the rule in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Pulmonary Arteriovenous Malformations

Faughnan

Lui

Wirth

et al. 2000

Chest

166

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“…Severe TBI is a strong candidate, but the injury characteristics in the studies reporting high risk limit generalizability (skull fracture/low GCS, penetrating war injuries, etc). 17 , 19 A high recurrence risk could also exist for patients with a first unprovoked seizure after a brain abscess 27 or new‐onset status epilepticus in MS, 15 but more studies are needed before this is taken to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Reported CI of seizure recurrence in specific etiologies is for HIV 30%‐65%, 21 , 22 , 23 neurocysticercosis 18%‐31%, 24 , 25 , 26 and brain abscess 81%. 27 …”

Section: Infectionsmentioning

confidence: 99%

Recurrence risk after a first remote symptomatic seizure in adults: Epilepsy or not?

Zelano

2021

Epilepsia Open

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The ILAE practical definition of epilepsy has a one seizure possibility to diagnose epilepsy after a first seizure if the recurrence risk is very high. The recurrence risk after a first seizure in brain disorders (first remote seizure) is often high, but varies with etiology, so more specific information is needed for clinical practice. This review describes etiology-specific recurrence risks in adults with a first remote seizure in stroke, traumatic brain injury, infections, dementia, multiple sclerosis, and tumors. Most studies are short, single center, and retrospective.

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Postoperative epilepsy in subdural suppurations

Abstract: The incidence of postoperative epilepsy in patients who had brain abscesses or subdural empyema is studied in 78 cases. This study is an attempt to answer the question whether prophylactic anticonvulsant drugs influence the natural history of this type of epilepsy.

Cited by 20 publications

References 4 publications

Factors affecting the outcome in subdural empyema.

Factors affecting the outcome in subdural empyema.

Diffuse Pulmonary Arteriovenous Malformations

Recurrence risk after a first remote symptomatic seizure in adults: Epilepsy or not?

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