neurologic disorders
Intracranial Epidural Abscess and Subdural Empyema
Diagnosis
Contrast-enhanced MRI Diagnosis of epidural abscess or subdural empyema is by contrast-enhanced MRI or, if MRI is not available, by contrast-enhanced CT. Blood and surgical specimens are cultured aerobically and anaerobically. Lumbar puncture provides little useful information and may precipitate transtentorial Brain Herniation . If intracranial epidural abscess or subdural empyema is suspected (eg, based on symptom duration of several days, focal deficits, or risk factors) in patients with meningeal signs, lumbar puncture is contraindicated until neuroimaging excludes a mass lesion. In infants, a subdural tap may be diagnostic and may relieve pressure. 