Subdural Effusion in Bacterial Meningitis Experience in Children Welfare Teaching Hospital


ABSTRACT:BACKGROUND:Subdural effusions occur in (10 - 33 %) of children with acute bacterial meningitis. Usually occur bilateral over frontoparietal region, although localized collections can develop over occipital region. Effusions are most common when meningitis results from H.influenzae .(45% of all effusions).OBJECTIVE:To find out the incidence , age distribution and type of bacteria involved in occurrence of subdural effusion in bacterial meningitis, to know the risk factors that might associated with subdural effusion .PATIENTS AND METHODS:from march 2010 – feb.2011 a Prospective study was done on 50 patients diagnosed and treated as meningitis, information's obtained from patients include (patient name, date of birth, sex, residency, duration of illness before admission, clinical presentation, and if antibiotics used prior to admission. Diagnostic inclusion criteria clinical and laboratory based. daily follow up of them .Brain CT was done to all of patients with meningitis after 7 days of treatment to roll out subdural effusion because some of the patients were asymptomatic.RESULTS:The study shows that incidence of subdural effusion in bacterial meningitis was (22.0%).It is most commonly occur in children below the age of (1) year, there was no significant difference between male and female . Regarding CSF analysis, there were no specific findings that indicate presence of subdural effusion. The majority of the patients show no growth of bacteria on CSF culture, blood culture and gram stain, the others show equal growth of (streptococcus pneumonia, H.influenzae and N.meningitidis). Regarding outcome the majority of the patients discharged well, only one patient had focal deficit and one patient died.CONCLUSION:There were no significant risk factors associated with development of subdural effusion. The majority of patients was discharged without any intervention and required follow up only. It's important for physician to maintain a high index of suspicion for diagnosis of subdural effusion .It is important to follow-up patients with meningitis by imaging study, because majority of patients with subdural effusion are asymptomatic.