Pediatric Emergency Care

Skip Navigation LinksHome > December 2013 - Volume 29 - Issue 12 > The Pediatric Headache That Would Not Go Away
Pediatric Emergency Care:
doi: 10.1097/PEC.0000000000000035
Illustrative Cases

The Pediatric Headache That Would Not Go Away

Dunn, Bryan MD; McCalla, Chad MD; Hiestand, Brian MD; O’Brien, Mary Claire MD

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Abstract: We describe the clinical presentation, radiographic findings, management, and outcome of a subdural empyema in a 14-year-old male with history of recent partially treated acute sinusitis. Subdural empyema is a rare but life threatening complication, usually following paranasal sinusitis, otitis media, mastoiditis, cranial surgery, a skull fracture, or from distant spread from sites such as a pulmonary infection. The initial evaluation should include a thorough history and physical examination, complete blood count, electrolytes, C-reactive protein, erythrocyte sedimentation rate, chest x-ray, urinalysis, and neuroimaging of the brain with intravenous contrast. If a subdural empyema is identified, then intravenous antibiotics should be initiated, and immediate neurosurgical consultation should be obtained to consider operative drainage.

© 2013 Lippincott Williams & Wilkins, Inc.


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