A subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura matter). If this fluid becomes infected, the condition is called a subdural empyema.

Causes

A subdural effusion is a rare complication of meningitis caused by bacteria. Subdural effusion is more common in infants.

It may also occur after head trauma.

Symptoms

Symptoms may include:

• Outward curving of a baby's skull's soft spot (bulging fontanelle)
• Abnormally wide spaces in the bony joints of a baby's skull (separated sutures)
• Increased head circumference
• Low energy (lethargy)

  Lethargy

  Fatigue is a feeling of weariness, tiredness, or lack of energy.

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• Persistent fever
• Seizures

  Seizures

  A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...

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• Vomiting
• Weakness or loss of movement on both sides of the body

Exams and Tests

Your health care provider will perform a physical exam and ask about the symptoms.

To detect the subdural effusion, tests that may be done include:

• CT scan of the head

  CT scan of the head

  A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.

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• Head size (circumference) measurements
• MRI scan of the head

  MRI scan of the head

  A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...

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• Ultrasound of the head

Treatment

Surgery to drain the effusion is often necessary. The fluid is usually tested. In rare cases, a permanent drainage device (shunt) is needed to drain fluid. Antibiotics may need to be given through a vein.

Treatment may include:

• Surgery to drain the effusion
• Drainage device, called a shunt, left in place for a short time or longer time
• Antibiotics given through a vein to treat an infection

Outlook (Prognosis)

Full recovery from a subdural effusion is expected. If nervous system problems continue, they are generally due to the meningitis, not the effusion. Long-term antibiotics are usually not needed.

Possible Complications

Complications of surgery may include:

• Bleeding
• Brain damage
• Infection

When to Contact a Medical Professional

Contact your provider if:

• Your child has recently been treated for meningitis and symptoms continue
• New symptoms develop

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