Alimehmeti R, Seferi A, Stroni G, Sallavaci S, Rroji A, Pilika K, Petrela M. Burr hole evacuation for infratentorial subdural empyema. World J Clin Cases 2013; 1(5): 172-175 [PMID: 24303495 DOI: 10.12998/wjcc.v1.i5.172]
Corresponding Author of This Article
Ridvan Alimehmeti, MD, PhD, Service of Neurosurgery, University Hospital Center “Mother Theresa”, Dibra Street, 370 Tirana, Albania. ridvanalimehmeti@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ridvan Alimehmeti, Arsen Seferi, Kliti Pilika, Mentor Petrela, Service of Neurosurgery, University Hospital Centre “Mother Theresa”, 270 Tirana, Albania
Gentian Stroni, Service of Infectious Diseases, University Hospital Centre “Mother Theresa”, 372 Tirana, Albania
Suela Sallavaci, Service of Otorhinolaryngology, University Hospital Centre “Mother Theresa”, 372 Tirana, Albania
Arben Rroji, Service of Neuroradiology, University Hospital Centre “Mother Theresa”, 270 Tirana, Albania
Author contributions: Alimehmeti R wrote the paper and operated on the patient; Seferi A performed the literature research and operated on the patient; Stroni G was in charge of the antibiotherapy and wrote the part of the article concerning conservative treatment; Sallavaci S performed the mastoidectomy and reviewed the article; Pilika K operated on the patient and revised the article; Rroji A prepared the photos; Petrela M reviewed the article for its intellectual content and approved the final version.
Correspondence to: Ridvan Alimehmeti, MD, PhD, Service of Neurosurgery, University Hospital Center “Mother Theresa”, Dibra Street, 370 Tirana, Albania. ridvanalimehmeti@hotmail.com
Telephone: +355-6-92102140 Fax: +355-4-2362641
Received: February 24, 2013 Revised: June 19, 2013 Accepted: July 4, 2013 Published online: August 16, 2013
Abstract
Infratentorial empyema is a life threatening condition and constitutes a neurosurgical emergency. Purulent mastoiditis and medial otitis is the most common origin and a thorough eradication of the purulent foci is mandatory. Decompression craniectomy has been primarily advised in the literature as the gold standard of the surgical treatment but burr hole evacuation when there the lack of cerebellar edema is less invasive and deemed equally efficient in the few reported cases. This is the report of a seventeen year old female who presented in a comatose state due to infratentorial empyema with acute hydrocephalus and who improved immediately after burr hole evacuation. Details of the surgical procedures are given. Mastoidectomy was completed, with the patient under combined antibiotherapy. She leads a normal life now, more than six years after surgery.
Core tip: It is general belief that subdural infratentorial empyema needs to be approached through an ample decompressive craniectomy. We present a case of infratentorial empyema managed successfully with burr hole evacuation of infratentorial empyema. We analyzed the characteristics of the case and reviewed the surgical techniques.
