Epidural and subdural abscesses

Introduction to epidural and subdural abscess Otitis media infection invades the dura mater, causing a part of the arachnoid and pia mater to form an abscess. This disease is not easy to be localized, and it is easy to spread to diffuse meningitis and die, so it is rare in clinical practice. The treatment of the disease is mainly in addition to the treatment of large doses of antibiotics, to perform mastoid incision, remove the lesions, often through the mastoid bone destruction area into the abscess, scrape the surrounding granulation, and expand drainage. If the abscess is very large, craniotomy should be performed outside the mastoid to remove large bone plates, cut the dura mater, or perform multiple cerebral circumcision drainage. According to Bannister's statistics, the cure rate of craniotomy with a craniotomy is higher than that of multiple trepanal drainage with a skull. At present, the mortality rate of this disease is still significantly higher than that of brain abscess. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: disturbance of consciousness epilepsy subdural abscess brain abscess

The cause of epidural and subdural abscess

It is caused by adjacent infections, such as paranasal sinusitis, otitis media, and cranial osteomyelitis, which can be directly spread to the epidural space. It can also be secondary to open brain injury, craniotomy and congenital sinus infection.

Prevention of epidural and subdural abscess

Actively treat adjacent infections and prevent the spread of infection.

Complications of epidural and subdural abscess Complications, disturbance of consciousness, epilepsy, subdural abscess, brain abscess

And can have conscious disturbances, epilepsy, focal neurological signs, inflammation can spread through the dura mater to the subdural and brain, resulting in purulent meningoencephalitis, subdural abscess, brain abscess or suppurative thrombotic sinusitis Wait.

Symptoms of epidural and subdural abscess Common symptoms Migratory abscess, hyperthermia meningitis, brain abscess, coma

This disease is easily confused with brain abscess and meningitis. It is best to perform cerebral angiography and brain CT scan, which can be seen in the placental abscess and the hemisphere compressed blood vessel shadow area.

Sudden disease, high fever, headache, etc., after 24 hours of onset, hemorrhoids, hemiplegia, and coma after 48 hours. According to Bannister, 1/4 of the patients died within 48 hours after admission.

Examination of epidural and subdural abscess

A CT scan of the head can show the separation of the dura mater and brain tissue from the inner plate of the skull at the site of the abscess (often in the vicinity of sinusitis or otitis media).

Diagnosis and diagnosis of epidural and subdural abscess

The soft tissue on the surface of the fracture line is swollen enough to indicate the possibility of EDH. Cerebral angiography is helpful for diagnosis and localization. It can be seen that the anterior cerebral artery is displaced to the contralateral side, and the middle cerebral artery is displaced inward or downward. The upper sagittal sinus is separated from the inner surface of the skull. CT scan can see a crescent-shaped high-density lesion in the skull between the inner surface of the skull and the surface of the brain. The CT value is between 40 and 100 HU, and the skull can be displayed. Fractures can also show other lesions associated with the brain, such as subdural hematoma, intracerebral hematoma, subarachnoid hemorrhage, and brain edema.

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