Epidural Empyema, Cranial

Research output: Chapter in Book/Report/Conference proceedingChapter


A cranial epidural empyema, or cranial epidural abscess, develops in the space between the dura and the inner table of the skull, and it is usually caused by the spread of infection from the frontal sinuses, middle ear, mastoid, or orbit. , or develops as a complication of a craniotomy or a compound skull fracture. The clinical presentation of a cranial epidural empyema is an unrelenting hemicranial headache with fever. Cranial magnetic resonance imaging is the diagnostic procedure of choice and immediate neurosurgical drainage is the definitive management step. Empirical antimicrobial therapy should include a combination of a third- or fourth-generation cephalosporin or meropenem, metronidazole, and nafcillin or vancomycin. Antibiotic coverage can be modified when the results of Gram's stain, bacterial culture, and sensitivities are known. Intravenous antibiotic therapy is continued for 4-6 weeks after surgical drainage of the epidural empyema, followed by 2 or 3 months of oral antibiotic therapy.

Original languageEnglish (US)
Title of host publicationEncyclopedia of the Neurological Sciences
PublisherElsevier Inc.
Number of pages1
ISBN (Electronic)9780123851574
ISBN (Print)9780123851581
StatePublished - Jan 1 2014


  • Cranial epidural abscess
  • Cranial epidural empyema

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Roos, K. (2014). Epidural Empyema, Cranial. In Encyclopedia of the Neurological Sciences (pp. 80). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-385157-4.00356-0