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Aspiration of parafalcine empyemas with flexible scope

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Abstract

Purpose

Subdural empyemas are considered neurosurgical emergencies, and the parafalcine location is particularly insidious. We revised the experience of general surgeons who are used to manage chronic pleural purulent collections with video-assisted thoracoscopy.

Methods

With a similar technique, we successfully aspirated a parafalcine empyema using a flexible scope avoiding a more invasive craniotomy. A review of the treatment options of empyematous collections is also provided, focusing particularly on the hazardous parafalcine location.

Results

The management of subdural empyemas poses different decision-making problems compared to common brain abscesses, urging a more rapid and holistic surgical treatment with minimally invasive approach. Endoscopic aspiration of parafalcine empyema was followed by complete recovery in our patient.

Conclusions

Flexible endoscopy is a promising method to obtain complete pus removal even from loculated collections through a bur hole, avoiding large craniotomies and consequent potential complications.

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Authors and Affiliations

  1. Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy

    Francesco Sammartino, Alessandro Fiorindi, Grazia Marina Mazzucco & Pierluigi Longatti

  2. Neurosurgery Unit, Department of Neurosciences, NOCSAE Modena Hospital, Via Giardini 1355, 41126 Baggiovara, Modena, Italy

    Alberto Feletti

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  1. Francesco Sammartino
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Correspondence to Alberto Feletti.

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Sammartino, F., Feletti, A., Fiorindi, A. et al. Aspiration of parafalcine empyemas with flexible scope. Childs Nerv Syst 32, 1123–1129 (2016). https://doi.org/10.1007/s00381-016-3082-6

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  • DOI: https://doi.org/10.1007/s00381-016-3082-6

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