Infratentorial Subdural Empyema Associated with Long Standing Occipital Dermal Sinus: Case Presentation

Abstract

Infratentorial subdural empyema is a rare form of life threatening intracranial infection, requiring immediate neurosurgical intervention. We present this 4-years-old girl with posterior fossa subdural empyema which is associated with congenital occipital dermal sinus. A contrast-enhanced CT scan showed an infratentorial supracerebellar hypodense fluid collection with the peripheral rim enhancement to the left of the midline that raised suspicion of a subdural empyema with supratentorial mild ventricular dilatation which was confirmed by MRI with contrast. The patient was operated through sub-occipital decompression and drainage of the collection and the samples was sent for culture and sensitivity. Dermal sinus can be a cause for intracranial infection and should be investigated to rule out intradural connection. Infratentorial subdural empyema should be managed urgently by neurosurgical intervention to prevent further life threatening complications.