This document discusses subdural abcesses, which are suppurative infections under the dura matter that can spread easily through cerebral fissures due to a lack of antibiotic penetration and barriers. Common causes include chronic otitis media, paranasal sinusitis, cranial traction devices, and trauma. Treatment involves drainage of the abcess via burr hole or craniotomy along with antibiotics, and outcomes differ depending on the source of the infection.

1. Dr Rahim Hamrah

2.  Pre 1943= Subdural Abcess
 Supporative infection under dura
matter
 No barrier for its distribution in
cerebral fissure
 Poor antibiotic penetration
 Different from intracerebral
abcess (inflammatory reaction
with fibrin and collagen capsule
 Complications: cerebral abcess,
cortical venous thrombosis with
venous infarction, regional
cerebritis

3.  Direct distribution
(diploid veins)
 Chronic otitis
media
 Paranasal sinusitis
 Cranial traction
device
 Trauma
 Others:
osteomyalitis,
pneumonia

4.  Differs with source of infection
 Sinusitis -> streptococci
 Trauma and iatrogenic -> staphylococci
 Sterile culture in 40%

6.  CT
 MRI
 LP

7.  Draingae with Burr hole
 Craniotomy
 antiobiotic