Abstract
Chronic sub-dural hematoma and subdural empyema are well known neurosurgical pathologies. Their coexistence is rare. The authors refered a case and discussed the various causes with a review of the literature. Comments : This is a 73 year-old woman, with a history of Alzheimer’s disease and cerebrovascular accident (CVA) treated with Salicylate acid 100 mg / day, who presented disturbance of consciousness and right hemiparesis. No notion of fever or head injury was founded. A Computed tomography (CT) scan without injection of contrast evoked the diagnosis of bilateral chronic subdural hematoma. The patient underwent surgery in emergency for neurological deterioration. After completion of two parietal burr holes from both sides and opening the dura, it was founded a chronic subdural hematoma (CSDH) on the left and a thick hard inflammatory membrane on the right, which contained a purulent material. Culture revealed Escherichia coli. Conclusion: Subdural empyema resulting from hematogenous seeding into a preexisting subdural hematoma is very rare.
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