A Case of Subdural Empyema Due to Dental Pathogen

Abstract

Subdural empyema is a rare but serious infection in the brain. Several etiologies and pathological mechanisms have been described. The team reports a case of subdural empyema due to dental pathogens, of which a limited number of cases have been reported. Radiological findings and medical management of this case are reviewed since prompt intervention reduces not only mortality and morbidity but also complications including sepsis, cranial osteomyelitis, and residual neurological deficit, among others.

Keywords: acute neurological deficit; burr holes procedure; dental caries; otorhinology infection; subdural empyema.

Figure 1. Initial CT without contrast showing right frontal hypodense fluid collection (A) and hypodense subdural collection in falx consistent with hematoma vs empyema (B)

Figure 2. Patient’s right upper and lower molar cavities and missing denture

Figure 3. Brain MRI with IV contrast showing right frontal lobe lesion, which can be infectious and/or neoplastic in nature (A), and subdural fluid collection along the falx towards the right midline extending into the right tentorium (B)