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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presentan 16 casos de empiema intracraneal extra&#237;dos de una serie de 90 abscesos intracraneales tratados en nuestro hospital desde 1978 a 1990&#44; lo que representa una frecuencia del 17&#44;7&#37;&#46; Las edades de los pacientes variaron entre 8 meses y 44 a&#241;os siendo la media de 25 a&#241;os&#46; Cl&#237;nicamente predominaron los s&#237;ntomas de hipertensi&#243;n intracraneal seguidos de fiebre y disminuci&#243;n del sensorio&#46; La localizaci&#243;n de los empiemas fue frontal en 8 casos&#44; parietal en 2&#44; temporal en 2 y en fosa posterior en el &#225;ngulo pontocerebeloso en 4 casos&#46; Las causas etiol&#243;gicas m&#225;s frecuentes fueron sinusitis en 7 casos&#44; y otitis en 6&#46; Once de los doce pacientes con empiemas supratentoriales fueron tratados con cirug&#237;a la cual consisti&#243; en craneotom&#237;a en 8 casos y tr&#233;panos evacuadores en 3&#46; Los 4 pacientes con empiemas localizados en la fosa posterior fueron tratados con craniectom&#237;a&#46; En un caso se utiliz&#243; tratamiento m&#233;dico con antibi&#243;ticos y control con TAC&#46; En 10 de los 16 casos el examen bacteriol&#243;gico fue positivo&#44; siendo los g&#233;rmenes predominantes el estreptococo y estafilococo&#46; Todos los pacientes una vez diagnosticados recibieron una combinaci&#243;n de dos o m&#225;s antibi&#243;ticos vari&#225;ndose el tipo del mismo seg&#250;n la especificidad del cultivo del l&#237;quido obtenido&#46; De los 16 casos 12 siguieron una buena evoluci&#243;n y 4 fallecieron tras empeoramiento neurol&#243;gico&#46; La craniectom&#237;a parece el tipo de tratamiento m&#225;s efectivo emple&#225;ndose el tratamiento m&#233;dico exclusivo en los casos muy localizados y sin focalidad cl&#237;nica&#46; El tratamiento del foco originario es preceptivo&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sixteen cases of subdural empyema extracted from a series of 90 intracranial abscesses seen in our service between 1978 and 1990 are presented&#46; Thus&#44; empyemas represent 17&#44;7&#37; of the total&#46; The age of the patients ranged from 8 months to 44 years&#44; the average being 25 years&#46; Headache&#44; vomiting fever and confusion were the predominant symptoms&#46; Empyemas 10cated at frontal level in eight cases&#44; at parietal level in two&#44; at temporal level in two&#44; and in the posterior fossa at level of the cerebello-pontine angle in four cases&#46; The most frequent etiological causes were sinusitis in seven cases and otitis in six&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Eleven supratentorial empyemas were treated surgicaIly&#59; eight patients with evacuation through a craniotomy and three by means of burrholes&#46; All patients with infratentorial empyema were treated by craniectomy&#46; Bacteriological examination was positive in ten of the 16 cases&#44; and multiple microorganisms were found in five cases&#44; streptococcus and staphylococcus being the predominant germs&#46; All patients were treated with antibiotics according to the bacteriological study&#46; Craniotomy seems to be the most effective surgical treatment&#46; Only one patient was treated exclusively with antibiotics&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The outcome was good in twelve cases and four patients died&#46; A medical or surgical treatment of the original focus is mandatory&#46;</p>"
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Empiemas subdllrales intracraneales
A. Isla, F. Alvarez, V. Pepín, M. García-Blázquez
Hospital «La Paz». Servicio de Neurocirugía. Madrid
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presentan 16 casos de empiema intracraneal extra&#237;dos de una serie de 90 abscesos intracraneales tratados en nuestro hospital desde 1978 a 1990&#44; lo que representa una frecuencia del 17&#44;7&#37;&#46; Las edades de los pacientes variaron entre 8 meses y 44 a&#241;os siendo la media de 25 a&#241;os&#46; Cl&#237;nicamente predominaron los s&#237;ntomas de hipertensi&#243;n intracraneal seguidos de fiebre y disminuci&#243;n del sensorio&#46; La localizaci&#243;n de los empiemas fue frontal en 8 casos&#44; parietal en 2&#44; temporal en 2 y en fosa posterior en el &#225;ngulo pontocerebeloso en 4 casos&#46; Las causas etiol&#243;gicas m&#225;s frecuentes fueron sinusitis en 7 casos&#44; y otitis en 6&#46; Once de los doce pacientes con empiemas supratentoriales fueron tratados con cirug&#237;a la cual consisti&#243; en craneotom&#237;a en 8 casos y tr&#233;panos evacuadores en 3&#46; Los 4 pacientes con empiemas localizados en la fosa posterior fueron tratados con craniectom&#237;a&#46; En un caso se utiliz&#243; tratamiento m&#233;dico con antibi&#243;ticos y control con TAC&#46; En 10 de los 16 casos el examen bacteriol&#243;gico fue positivo&#44; siendo los g&#233;rmenes predominantes el estreptococo y estafilococo&#46; Todos los pacientes una vez diagnosticados recibieron una combinaci&#243;n de dos o m&#225;s antibi&#243;ticos vari&#225;ndose el tipo del mismo seg&#250;n la especificidad del cultivo del l&#237;quido obtenido&#46; De los 16 casos 12 siguieron una buena evoluci&#243;n y 4 fallecieron tras empeoramiento neurol&#243;gico&#46; La craniectom&#237;a parece el tipo de tratamiento m&#225;s efectivo emple&#225;ndose el tratamiento m&#233;dico exclusivo en los casos muy localizados y sin focalidad cl&#237;nica&#46; El tratamiento del foco originario es preceptivo&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sixteen cases of subdural empyema extracted from a series of 90 intracranial abscesses seen in our service between 1978 and 1990 are presented&#46; Thus&#44; empyemas represent 17&#44;7&#37; of the total&#46; The age of the patients ranged from 8 months to 44 years&#44; the average being 25 years&#46; Headache&#44; vomiting fever and confusion were the predominant symptoms&#46; Empyemas 10cated at frontal level in eight cases&#44; at parietal level in two&#44; at temporal level in two&#44; and in the posterior fossa at level of the cerebello-pontine angle in four cases&#46; The most frequent etiological causes were sinusitis in seven cases and otitis in six&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Eleven supratentorial empyemas were treated surgicaIly&#59; eight patients with evacuation through a craniotomy and three by means of burrholes&#46; All patients with infratentorial empyema were treated by craniectomy&#46; Bacteriological examination was positive in ten of the 16 cases&#44; and multiple microorganisms were found in five cases&#44; streptococcus and staphylococcus being the predominant germs&#46; All patients were treated with antibiotics according to the bacteriological study&#46; Craniotomy seems to be the most effective surgical treatment&#46; Only one patient was treated exclusively with antibiotics&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The outcome was good in twelve cases and four patients died&#46; A medical or surgical treatment of the original focus is mandatory&#46;</p>"
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