Download Full Text (676 KB)

Download Abstract (65 KB)


East Florida


HCA Florida Westside Hospital


Internal Medicine

Document Type


Publication Date



intracranial subdural empyema, ISE, altered mental status


Internal Medicine | Medicine and Health Sciences | Nervous System Diseases | Neurology


Intracranial subdural empyema (ISE) is a rare infection of brain, which occurs when pus is collectively located in the space between dura and arachnoid matter. In the past, its mortality was nearly 100%, if it was not treated appropriately within 24-48 hours. Thanks to improvement of diagnostic modalities and treatment, its mortality has dramatically decreased. Though, it can still cause a devastating consequence if it is not managed in a timely manner. The common etiology of ISE is different depending on the age group. In younger patients, it occurs frequently as a complication of infection in neighboring structures like sinusitis or otitis. On the other hand, in older patients, neurosurgical procedures are mostly related to ISE even though the incidence is low. Clinical presentation is similar regardless of etiologies, and it is more related to an anatomic region. Based on the clinical presentation and findings on imaging studies if suspicion for ISE is high, broad-spectrum antibiotic therapy must be initiated immediately. Most cases need surgical evacuation as well. We present a 76-year-old male who had a recent history of complication-free craniectomy due to a benign tumor and a month later developed AMS, fever, unilateral weakness and aphasia secondary to ISE in the left temporo-parietal lobe.

Sudden Onset AMS, Focal Weakness, Fever and Aphasia due to Intracranial Subdural Empyema in Left Temporo-Parietal Lobe



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.