Yıl: 2023 Cilt: 29 Sayı: 4 Sayfa Aralığı: 514 - 522 Metin Dili: İngilizce DOI: 10.14744/tjtes.2022.56706 İndeks Tarihi: 24-07-2023

Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases

Öz:
BACKGROUND: Subdural empyemas (SDEs) are rare intracranial infections mostly secondary to sinusitis. Incidence of SDEs is 5–25%. Interhemispheric SDEs are even rarer, which makes their diagnosis and treatment difficult. Aggressive surgical interventions and wide-spectrum antibiotics are needed for treatment. In this retrospective clinical study, we intended to evaluate the results of surgical management supported by antibiotics in patients with interhemispheric SDE. METHODS: Clinical and radiological features, medical and surgical management and outcomes of 12 patients treated for interhemispheric SDE have been evaluated. RESULTS: 12 patients were treated for interhemispheric SDE between 2005 and 2019. Ten (84%) were male, two (16%) were female. Mean age was 19 (7–38). Most common complaint was headache (100%). Five patients were diagnosed with frontal sinusitis prior SDE. Initially, three patients (27%) underwent burr hole aspiration and ten patients (83%) underwent craniotomy. In one patient both were done in the same session. Six patients were reoperated (50%). Weekly magnetic resonance imaging and blood tests were used for follow-up. All patients received antibiotics for at least 6 weeks. There was no mortality. Mean follow-up period was 10 months. CONCLUSION: Interhemispheric SDEs are rare, challenging intracranial infections that have been related to high morbidity and mortality rates in the past. Both antibiotics and surgical interventions play role in treatment. Careful choice of surgical approach and repeated surgeries if necessary, accompanied by appropriate antibiotic regimen, leads to good prognosis reducing morbidity and mortality.
Anahtar Kelime:

İnterhemisferik subdural ampiyemlerin cerrahi tedavisi: Literatür taraması ve 12 olguluk seri

Öz:
AMAÇ: Subdural ampiyemler çoğunlukla sinuzite sekonder gelişen nadir intrakranyal enfeksiyonlardır. Yıllık insidansları %5–%25 arasında raporlanmıştır. İnterhemisferik yerleşimli subdural ampiyemler ise daha da nadir olup tanıları ve tedavileri zordur. Agresif cerrahi girişimler ve geniş spektrumlu antibiyotikler tedavinin bel kemiğini oluşturmaktadır. Geriye dönük çalışmamızda, antibiyoterapinin yanı sıra cerrahi tedavi uygulanmış olan interhemisferik subdural ampiyemli hastaların irdelenmesi amaçlanmıştır. GEREÇ VE YÖNTEM: İnterhemisferik subdural ampiyem tanısıyla opere edilen 12 hastanın klinik ve radyolojik özellikleri, tıbbi ve cerrahi tedavilerinin detayları ve prognozları geriye dönük olarak incelenmiştir. BULGULAR: 2005 ve 2019 seneleri arasında interhemisferik subdural ampiyem tanılı 12 hasta tedavi edilmiştir. Hastaların onu (%84) erkek ve ikisi (%16) kadındır. Ortalama yaş 19 (7–38)’dur. En sık şikayet baş ağrısıdır (%100). Hastaların beşi ampiyem tanısından evvel frontal sinuzit tanısı almışlardır. İlk cerrahi girişim açısından üç (%27) hastaya burrholeden aspirasyon ve on (%83) hastaya kranyotomi uygulanmıştır. Bir hastada her iki cerrahi yöntem aynı seansta uygulanmıştır. Takiplerinde altı (%50) hastada ikinci cerrahi ihtiyacı olmuştur. Hasta takibinde haftalık manyetik rezonans görüntüleme ve kan testleri kullanılmıştır. Tüm hastalar en az altı hafta boyunca geniş spektrumlu antibiyotik kullanmıştır. Mortalite yoktur. Ortalama takip süresi 10 aydır. TARTIŞMA: İnterhemisferik subdural ampiyemler nadiren rastlanan ve tedavisi zor intrakranyal enfeksiyonlar olup geçmişte yüksek mortalite ve morbidite ile ilişkilendirilmiştir. Tedavi seçenekleri arasında cerrahi ve antibiyoterapi bulunmaktadır. Cerrahi tekniğin dikkatle seçilmesi ve ihtiyaç duyulan olgularda ikinci cerrahiden kaçınılmaması, uygun antibiyotik rejimeni ile beraber, sağ kalımı iyileştirmektedir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA güçlü d, DÖLEN D, DOLAŞ İ, BAŞARAN S, ÜNAL T, Yılmaz E, Alkır G, ÖZLÜ H, aydoseli a, Kubilay M, Sencer A (2023). Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. , 514 - 522. 10.14744/tjtes.2022.56706
Chicago güçlü doğan güçlühan,DÖLEN Duygu,DOLAŞ İlyas,BAŞARAN Seniha,ÜNAL Tugrul Cem,Yılmaz Ezgi,Alkır Görkem,ÖZLÜ HARUN MEHMET,aydoseli aydin,Kubilay Mitra,Sencer Altay Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. (2023): 514 - 522. 10.14744/tjtes.2022.56706
MLA güçlü doğan güçlühan,DÖLEN Duygu,DOLAŞ İlyas,BAŞARAN Seniha,ÜNAL Tugrul Cem,Yılmaz Ezgi,Alkır Görkem,ÖZLÜ HARUN MEHMET,aydoseli aydin,Kubilay Mitra,Sencer Altay Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. , 2023, ss.514 - 522. 10.14744/tjtes.2022.56706
AMA güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. . 2023; 514 - 522. 10.14744/tjtes.2022.56706
Vancouver güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. . 2023; 514 - 522. 10.14744/tjtes.2022.56706
IEEE güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A "Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases." , ss.514 - 522, 2023. 10.14744/tjtes.2022.56706
ISNAD güçlü, doğan güçlühan vd. "Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases". (2023), 514-522. https://doi.org/10.14744/tjtes.2022.56706
APA güçlü d, DÖLEN D, DOLAŞ İ, BAŞARAN S, ÜNAL T, Yılmaz E, Alkır G, ÖZLÜ H, aydoseli a, Kubilay M, Sencer A (2023). Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. Ulusal Travma ve Acil Cerrahi Dergisi, 29(4), 514 - 522. 10.14744/tjtes.2022.56706
Chicago güçlü doğan güçlühan,DÖLEN Duygu,DOLAŞ İlyas,BAŞARAN Seniha,ÜNAL Tugrul Cem,Yılmaz Ezgi,Alkır Görkem,ÖZLÜ HARUN MEHMET,aydoseli aydin,Kubilay Mitra,Sencer Altay Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. Ulusal Travma ve Acil Cerrahi Dergisi 29, no.4 (2023): 514 - 522. 10.14744/tjtes.2022.56706
MLA güçlü doğan güçlühan,DÖLEN Duygu,DOLAŞ İlyas,BAŞARAN Seniha,ÜNAL Tugrul Cem,Yılmaz Ezgi,Alkır Görkem,ÖZLÜ HARUN MEHMET,aydoseli aydin,Kubilay Mitra,Sencer Altay Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. Ulusal Travma ve Acil Cerrahi Dergisi, vol.29, no.4, 2023, ss.514 - 522. 10.14744/tjtes.2022.56706
AMA güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. Ulusal Travma ve Acil Cerrahi Dergisi. 2023; 29(4): 514 - 522. 10.14744/tjtes.2022.56706
Vancouver güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases. Ulusal Travma ve Acil Cerrahi Dergisi. 2023; 29(4): 514 - 522. 10.14744/tjtes.2022.56706
IEEE güçlü d,DÖLEN D,DOLAŞ İ,BAŞARAN S,ÜNAL T,Yılmaz E,Alkır G,ÖZLÜ H,aydoseli a,Kubilay M,Sencer A "Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases." Ulusal Travma ve Acil Cerrahi Dergisi, 29, ss.514 - 522, 2023. 10.14744/tjtes.2022.56706
ISNAD güçlü, doğan güçlühan vd. "Surgical management of interhemispheric subdural empyemas: Review of the literature and report of 12 cases". Ulusal Travma ve Acil Cerrahi Dergisi 29/4 (2023), 514-522. https://doi.org/10.14744/tjtes.2022.56706