• Pediatric emergency care · Dec 2013

    Case Reports

    The pediatric headache that would not go away.

    • Bryan Dunn, Chad McCalla, Brian Hiestand, and Mary Claire O'Brien.
    • From the Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
    • Pediatr Emerg Care. 2013 Dec 1;29(12):1283-6.

    AbstractWe describe the clinical presentation, radiographic findings, management, and outcome of a subdural empyema in a 14-year-old male with history of recent partially treated acute sinusitis. Subdural empyema is a rare but life threatening complication, usually following paranasal sinusitis, otitis media, mastoiditis, cranial surgery, a skull fracture, or from distant spread from sites such as a pulmonary infection. The initial evaluation should include a thorough history and physical examination, complete blood count, electrolytes, C-reactive protein, erythrocyte sedimentation rate, chest x-ray, urinalysis, and neuroimaging of the brain with intravenous contrast. If a subdural empyema is identified, then intravenous antibiotics should be initiated, and immediate neurosurgical consultation should be obtained to consider operative drainage.

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