brain, spinal cord, and nerve disorders
Intracranial Epidural Abscess and Subdural Empyema
Introduction
Anintracranial epidural abscessis a pocket of pus that develops between the skull and the top layer of tissues (dura mater) covering the brain. Asubdural empyemais a pocket of pus that develops between the dura mater and the middle layer of the tissues (arachnoid mater) covering the brain. (See also Overview of Brain Infections .) Intracranial epidural abscesses and subdural empyemas may result from a sinus or an ear infection or from conditions that allow bacteria to enter the skull, such as a head injury or head surgery Fever, headache, sleepiness, vomiting, seizures, a stiff neck, and other signs of brain dysfunction may develop over several days. Without treatment, symptoms progress rapidly, leading to coma and death. To diagnose these disorders, doctors do magnetic resonance imaging or computed tomography with a contrast agent. Treatment includes surgical drainage, antibiotics, and sometimes drugs to prevent seizures or to reduce pressure within the skull. Intracranial epidural abscesses and subdural empyemas develop outside the brain itself but within the skull (intracranial): Intracranial epidural abscess: Between the dura mater (the outer layer of tissue covering the brain) and the skull Subdural empyema: Between the arachnoid mater (the middle layer of tissue covering the brain) and the dura mater Within the skull, the brain is covered by three layers of tissue called the meninges. 