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Ned Tijdschr Geneeskd · Apr 2000
Case Reports[Clinical thinking and decision making in practice. A student with sudden headache].
- R Saxena, W P Vandertop, G L Küppers, and J C van Swieten.
- Afd. Neurologie, Academisch Ziekenhuis Rotterdam-Dijkzigt. saxena@neur.azr.nl
- Ned Tijdschr Geneeskd. 2000 Apr 15;144(16):741-5.
AbstractA previously healthy man aged 18 years suddenly developed a severe headache, followed by nausea, vomiting, fever. During the following weeks a left-sided hemiparesis developed. CT of the brain revealed a pansinusitis and a frontal epidural empyema. A few days after surgical drainage his condition deteriorated and subsequent CT showed a right-sided subdural empyema. This was surgically evacuated and followed by long-term high-dose intravenous antibiotic therapy. The patient made a complete recovery. A sudden severe headache can be caused by an intracranial infection and intracranial pus collections can occur in the subdural as well as in the epidural space. Epidural empyema is a limited disease with relatively mild symptoms and a favourable prognosis, whereas subdural empyema may rapidly spread and cause severe disease with a poor prognosis. Quick antibiotic treatment and surgical drainage are required.
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