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East African Journal of Neurological Sciences
Von Mireille Georgette Moumi, Leonel Tanji Njei, Joseph Fondop und 4 weiteren.
Inhalt auf Englisch
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Subdural empyema is a serious infection that can be life-threatening. It usually occurs as a complication of an otologic, odontogenic, sinogenic, rhinogenic, or cranial infection. Male sex is a notable risk factor in young subjects. Late diagnosis leads the non-specific clinical presentation toward a severe neurological form with coma and rapidly irreversible hemiplegia in the absence of urgent management. The objective was to describe the clinical, laboratory, radiological, therapeutic, and management outcomes of two cases of severe subdural empyema at Douala General Hospital. Case summary: We report two clinical cases of severe forms of subdural empyema with coma in young males aged 18 and 25 years, illustrating the relevance of continuous irrigation and catheter drainage in addition to the trepanation technique, aspiration, and drainage at the Douala General Hospital (DGH) in Cameroon. The patients gave their informed consent for the anonymous publication of their clinical information. Both patients showed rapid and remarkable clinical improvement after treatment. The origin was both odontogenic and sinogenic for the first case and sinogenic for the second case. No persistent neurological deficit was found after 3 months of follow-up. The average length of hospitalization was 15 days. Clinical, laboratory and imaging follow-up showed regression of all symptoms.
There is no consensus in the treatment of subdural empyema (SDE) in its fulminant form. Continuous irrigation and catheter drainage, in addition to conventional neurosurgical intervention, appear to be promising for improving morbidity and mortality, particularly in patients with poor prognostic factors.
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