Subdural empyema complicated after trepanation and drainage of chronic subdural hematoma: A case report

RATIONALE: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases. However, complicated subdural empyema rarely occurs after trepanation and drainage of chronic subdural hematoma. PATIENT CONCERNS: A male patient (77 years old) was admitted to the hospital on the 2nd day of fever after an undergoing a “trepanation and drainage of chronic subdural hematoma” operation at a local hospital. After admission, the patient was treated with an emergency operation in which a subdural abscess was diagnosed and then administered antibiotics after the operation. DIAGNOSIS: According to the clinical manifestations, intraoperative findings of imaging examination and the results of pus culture, the diagnosis was subdural empyema. INTERVENTION: We surgically removed the subdural empyema. Postoperative antibiotics were administered according to the results of bacterial culture. OUTCOMES: At 3 months after the operation, the patient returned to the hospital for reexamination and was found to have achieved a good recovery and good self-care. LESSONS: Subdural empyema after trepanation and drainage of chronic subdural hematoma is a very rare and severe disease. Early diagnosis and operative intervention as well as the intravenous administration of antibiotics can improve the prognosis of patients and enhance their quality of life.