Head CT > Infection > Subdural Empyema

Subdural Empyema

Subdural empyema is usually due to meningitis, sinusitis, trauma or prior surgery. It is a neurosurgical emergency. Subdural empyema leads to rapid clinical deterioration, especially if it is due to sinusitis. On CT it appears as an isodense or hypodense extra-axial mass. It has a lentiform or crescentic shape.
The margin of collection often enhances with contrast material administration due to the presence of granulation tissue or subjacent cortical inflammation.

Notice the heterogeneous subdural fluid collection.

In the same patient, post contrast administration,
notice the patchy enhancement of the fluid collection.

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