Intracranial Epidural Suppuration: The Occult Empyema

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Abstract
Four patients with intracranial epidural empyema are discussed, illustrating the variety of clinical presentations of this process. A review of the ear, nose, and throat and neurosurgical literature is provided. The common incidental clinical presentation of this lesion is emphasized. Its symptoms are overshadowed almost invariably by concomitant disease processes, which include acute sinusitis, osteomyelitis, subgaleal empyema, subdural empyema, and subcortical intrapa-renchymal abscess. The diagnosis and treatment of intracranial epidural empyema are still dependent upon a high index of clinical suspicion.

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