Epidural abscess refers to a purulent infection located between the inner table of the skull and the dura mater. It is relatively rare among intracranial abscesses and is often caused by direct invasion from adjacent sources of infection, such as otitis media, mastoiditis, or cranial osteomyelitis, which erode the inner table of the skull. It can also result from retrograde spread via emissary veins due to infections in the head, face, or paranasal sinuses. The progression of the condition is prone to complications such as subdural abscess and intracerebral abscess. The main clinical manifestations of epidural abscess are systemic infection symptoms, while signs of increased intracranial pressure and focal neurological deficits are less prominent. Treatment primarily involves surgical intervention and systemic antibiotic therapy, with a generally favorable prognosis.

bubble_chart Clinical Manifestations

1. Systemic infection symptoms, the patient presents with fever, headache, vomiting, general lack of strength, drowsiness, and other manifestations. 2. The site of the abscess has skull osteomyelitis, showing local swelling and tenderness, but neurological localization and symptoms of increased intracranial pressure are not obvious.

bubble_chart Diagnosis

1. History of skull osteomyelitis, sinusitis, otitis media, mastoiditis, or head and facial infections. 2. Manifestations of systemic infection symptoms. 3. Presence or absence of meningeal irritation signs or encephalopathic symptoms. 4. Cerebral angiography, cranial CT, or MRI showing lesions. 5. Pus extracted from the epidural space during skull trepanation or puncture.

1. Treat the primary source of infection. 2. Surgical treatment. 3. Systemic application of antibiotics. Expert Advice: Epidural abscesses are primarily caused by direct invasion from adjacent areas such as otitis media, sinusitis, or skull osteomyelitis. Therefore, prevention is key. Thorough and proactive treatment of the primary infection source can reduce its occurrence. If symptoms of the primary infection worsen and systemic infection symptoms appear, promptly consult a specialist for examination and a cranial CT scan, which can generally confirm the diagnosis. Once diagnosed, immediate surgery and antibiotic use are necessary. The prognosis is good. However, delayed diagnosis and treatment may lead to the spread of inflammation, resulting in complications such as subdural abscesses or brain abscesses, which can be life-threatening.

bubble_chart Cure Criteria

1. Cured: The abscess has been eliminated, and intracranial pressure has returned to normal. No signs of intracranial inflammation are present, and cerebrospinal fluid examination is normal. 2. Improved: The abscess has been eliminated, intracranial pressure has improved, and signs of intracranial inflammation have lessened. 3. Not Cured: The abscess has spread, intracranial pressure has increased, and symptoms have worsened.