Reporte de Caso: Empiema subdural a consecuencia de sinusitis complicada en paciente pediátrico: informe de caso

Abstract

Introduction: synogenic subdural empyema is a suppurative infection that forms in the space between the dura mater and the arachnoid membranes. It is a rare entity, so it is important to maintain the level of alert in the face of neurological focalities, associated with the failure to improve headache symptoms with the usual medication. Case presentation: adolescent patient, male, mixed-race, 11 years old, urban origin, with a history of recurrent kidney stones who, two weeks after being discharged from an admission for left maxillary and ethmoidal sinusitis, was readmitted with symptoms of headache. oppressive, constant character, of moderate to great intensity, holocranial, with occasional vomiting, fever in figures of 39-40 degrees Celsius, difficult to control, drowsiness, two generalized tonic-clonic convulsive events, total right hemiparesis, direct, predominantly crural and Babinski sign on that side. It was decided to perform a simple single-slice skull tomography, contrast-enhanced skull tomography and a nuclear magnetic resonance, diagnosing subdural empyema. An emergency surgical alternative was decided with favorable postoperative recovery. Conclusions: subdural empyema has been described as one of the most urgent neurosurgical emergencies. Its effective diagnosis is nuclear magnetic resonance as the best option. The case in question served to demonstrate the need to deepen the knowledge about subdural empyema as a complication of sinusitis, highlighting the management to be carried out in its presence as a means of learning for health personnel.