# Subdural Empyema as a Sequela of Severe Erosive Sinusitis: A Case Report

## TL;DR

A rare case of subdural empyema caused by severe sinusitis is presented, showing successful treatment with surgery and antibiotics.

## Contribution

This case report provides clinical insights into managing subdural empyema through timely surgical and antibiotic interventions.

## Key findings

- A 45-year-old male with progressive neurological symptoms was diagnosed with subdural empyema.
- The patient improved after surgical drainage and a combination of linezolid, cefepime, and metronidazole.
- The case emphasizes the importance of prompt intervention in treating subdural empyema.

## Abstract

Intracranial subdural empyema is a rare but critical neurosurgical emergency marked by pus accumulation between the brain and the dura mater. It typically arises from bacterial or fungal infections, often secondary to sinusitis, otitis media, or head trauma. Symptoms can range from mild headaches to significant neurological deficits and altered mental status. Diagnosis is confirmed through advanced imaging techniques such as MRI and CT scans. Timely intervention is essential to prevent neurological damage and systemic complications, usually involving surgical drainage and antimicrobial therapy. We present the case of a 45-year-old male who visited the emergency room several times with progressive lethargy and altered mental status. He was admitted and later transferred to our trauma center for a suspected subdural hematoma. An emergent right-sided craniotomy was performed, and a subdural empyema was found. The patient improved following subdural drainage and antibiotic treatment, including 600 mg linezolid every 12 hours, 2 g cefepime every eight hours, and 500 mg metronidazole every eight hours. This case highlights the effectiveness of prompt medical and surgical intervention in managing this rare condition and offers valuable insights for improving future patient outcomes.