Intracranial subdural empyema is also known as or subsumes Pachymeningitis interna, Purulent pachymeningitis, and Subdural abscess. -ed.
Intracranial subdural empyema represents infection arising in the cleavage plane between the cranial dura mater and the arachnoid. Although the condition is most frequently associated with sinusitis, it may also occur as a complication of otitis, other cranial or dental infections, neurosurgical procedures, or cranial trauma. Intracranial subdural empyema represents one of the most dangerous of all intracranial processes because it can spread rapidly to cover an entire cerebral hemisphere or much of the posterior fossa, producing a rapidly expanding, potentially fatal mass lesion. In this review, Dr. John Greenlee, Professor of Neurology at the University of Utah School of Medicine and staff neurologist at the George E Wahlen Veterans Affairs Medical Center in Salt Lake City, Utah, reviews the pathogenesis, clinical features, diagnosis, and treatment of this disorder.