Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2018; 6(14): 825-829
Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.825
Subdural empyema complicated with intracranial hemorrhage in a postradiotherapy nasopharyngeal carcinoma patient: A case report and review of literature
Jun-Chen Chen, Dian-Hui Tan, Ze-Bin Xue, Sen-Yuan Yang, Yong Li, Run-Long Lai
Jun-Chen Chen, Dian-Hui Tan, Ze-Bin Xue, Sen-Yuan Yang, Yong Li, Run-Long Lai, Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Chen JC and Tan DH contributed equally to this work and should be considered as co-first authors; Chen JC and Tan DH participated in the patient treatment and wrote the manuscript; Xue ZB and Yang SY collected the clinical data and performed the literature review; Li Y and Lai RL performed the operation; Lai RL helped to design and revise the paper.
Informed consent statement: Written informed consent was obtained from the patient and her family.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: 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/
Correspondence to: Run-Long Lai, MD, Chief Doctor, Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, Guangdong Province, China. runlonglai@163.com
Telephone: +86-754-88258290 Fax: +86-754-88259850
Received: August 4, 2018
Peer-review started: August 5, 2018
First decision: August 31, 2018
Revised: September 21, 2018
Accepted: October 12, 2018
Article in press: October 11, 2018
Published online: November 26, 2018
Abstract

The prevalence of nasopharyngeal carcinoma (NPC) is higher in southern China, Hong Kong, and Taiwan than in other areas in the world. Radiotherapy is an important part of treatment for NPC patients, especially those with stage III/IV disease. Subdural empyema is a rare but life-threatening complication in postradiotherapy NPC patients which should be paid more attention. Here, we present the case of a 64-year-old female postradiotherapy NPC patient with subdural empyema complicated with intracranial hemorrhage. She was treated by burr-hole surgery but unfortunately died because of recurrent intracranial hemorrhage. The mechanisms potentially underlying the formation of subdural empyema in postradiotherapy NPC patients and the surgical strategies that can be used in these patients are discussed in this report.

Keywords: Intracranial hemorrhage, Nasopharyngeal carcinoma, Postradiotherapy, Subdural empyema, Case report

Core tip: This paper describes subdural empyema as a rare but life-threatening complication in postradiotherapy nasopharyngeal carcinoma. The opportunistic bacterial infection should be carefully considered in these immunosuppressive patients. A literature review was performed to discuss the potentially underlying mechanisms, imaging study, and comparison of two surgical strategies. It is noted that the prognosis appears to be more strongly related to the level of consciousness at the time of surgery.