CASE OF TRANSVERSO-SIGMOID THROMBOPHLEBITIS WITH BILATERAL SUBDURAL EMPYEMA

Subdural empyema is a life-threatening infection of the intracranial space, with very high rates of mortality if not appropriately diagnosed and treated. When managed well, with surgery and antibiotics, patients usually recover without significant residual deficits. The route of spread of infection and the organism involved needs to be investigated for complete eradication of the disease. We present the case of a young girl, without any co-morbidities, initially diagnosed as having Cerebral Venous Sinus Thrombosis, and treated accordingly, who later suffered a cascade of complications that proved almost fatal. She was managed successfully at our institution, and recovered completely in the end, and is currently leading a normal life. A pathophysiological analysis of her disease process was made retrospectively, and indicated how a seemingly innocuous dental infection spread over time to produce a life-threatening subdural empyema, involving a fastidious opportunistic commensal organism. We present an account of the same.