Acute subdural empyema caused by rupture of brain abscess after lumbar puncture:a case report
ZHANG Li-cheng
ZHONG Hua-ying
XIN Zhen-xue
WANG Xin-zhi
MA Jin-bang
LI Yi-ping
Abstract：Subdural abscess is a relatively uncommon neurological infection,and the rupture of a brain abscess following lumbar puncture leading to acute subdural abscess is exceedingly rare.This article reports a case of a 55-year-old woman who was admitted with intermittent headaches over several months.MRI revealed a brain abscess adjacent to the tentorium cerebelli.Following intravenous mannitol infusion,a lumbar puncture was performed for cerebrospinal fluid analysis.Post-procedurally,the patient experienced acute clinical deterioration.Follow-up CT and MRI revealed a right occipital lobe brain abscess with subdural empyema and midline structural shift.Cerebral herniation was suspected,prompting emergency surgical evacuation of the subdural empyema and decompressive craniectomy.Postoperative antibiotic therapy was administered.A follow-up head MRI at 4 months post-surgery showed complete resolution of the abscess.This case highlights that caution is warranted when performing lumbar puncture in patients with large brain abscesses or those located near the cerebral surface or tentorium cerebelli,as such procedures may precipitate abscess rupture.Once rupture occurs,leading to subdural empyema and cerebral herniation,prompt surgical intervention and aggressive anti-infective treatment are imperative.
Keywords：Brain abscessLumbar punctureSubdural empyema
Publication Date：2025-03-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 187-189 )