Epidural abscess (intracranial): Difference between revisions
m (Rossdonaldson1 moved page Epidural Abscess (Intracranial) to Epidural abscess (intracranial)) |
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*CT w/ IV contrast is reasonable alternative | *CT w/ IV contrast is reasonable alternative | ||
== | ==Differential Diagnosis== | ||
*Any intracranial mass | *Any intracranial mass | ||
**ICH | **[[ICH]] | ||
**Tumor | **Tumor | ||
**Brain abscess | **[[Brain abscess]] | ||
**Subdural empyema | **[[Subdural empyema]] | ||
== Treatment == | == Treatment == | ||
Revision as of 18:04, 9 February 2015
Background
- Much less common than spinal epidural abscess (1:9)
- Usually caused by local spread of infection or local inoculation during surgery or trauma
- Usually isolated to calvarium due to adherence of dura to foramen magnum
Clinical Features
- Symptoms of intracranial mass
- papilledema
- focal neurologic symptoms
- Headache
- Vomiting/nausea
Diagnosis
- Suspect diagnosis based on clinical history and physical exam
- Imaging modality of choice is MRI
- CT w/ IV contrast is reasonable alternative
Differential Diagnosis
- Any intracranial mass
- ICH
- Tumor
- Brain abscess
- Subdural empyema
Treatment
- Surgical decompresion
- Antibiotics
- Vanco + metronidazole + either cefotaxime or ceftriaxone or ceftazadine
- Ceftazidine is preferred if pseudomonas is considered likely
- Can substitute nafcillin or oxacillin for vanco if not MRSA
- Treat for 6-8 weeks
- If likely nasopharyngeal source (sinusitis, mastoiditis), may consider regiment covering strep, hemophilus, and aerobes
- Vanco + metronidazole + either cefotaxime or ceftriaxone or ceftazadine
See Also
Sources
Uptodate