Subdural empyema complicated with intracranial hemorrhage in a postradiotherapy nasopharyngeal carcinoma patient: A case report and review of literature

Abstract

The prevalence of nasopharyngeal carcinoma (NPC) is higher in southern China, Hong Kong, and Taiwan than in other areas in the world. Radiotherapy is an important part of treatment for NPC patients, especially those with stage III/IV disease. Subdural empyema is a rare but life-threatening complication in postradiotherapy NPC patients which should be paid more attention. Here, we present the case of a 64-year-old female postradiotherapy NPC patient with subdural empyema complicated with intracranial hemorrhage. She was treated by burr-hole surgery but unfortunately died because of recurrent intracranial hemorrhage. The mechanisms potentially underlying the formation of subdural empyema in postradiotherapy NPC patients and the surgical strategies that can be used in these patients are discussed in this report.

Keywords: Intracranial hemorrhage; Nasopharyngeal carcinoma; Postradiotherapy; Subdural empyema; Case report

Core tip: This paper describes subdural empyema as a rare but life-threatening complication in postradiotherapy nasopharyngeal carcinoma. The opportunistic bacterial infection should be carefully considered in these immunosuppressive patients. A literature review was performed to discuss the potentially underlying mechanisms, imaging study, and comparison of two surgical strategies. It is noted that the prognosis appears to be more strongly related to the level of consciousness at the time of surgery.