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KMID : 0377619700190050359
Korean Jungang Medical Journal
1970 Volume.19 No. 5 p.359 ~ p.363
Use of Micropaque Barium Sulfate in Radiographic Visualization of a Huge Subdural Empyema in an infant.



Abstract
The Thorotrast had been regarded as a indispensable adjunct to the treatment of the intracranial abscess for last several decades.
Unfortunately, the thorotrast is radioactive and produce the delayed cauda equina neuritis when injected into the subarachnoid space.
Recently, because of these dangers, Micropaque Barium Sulfate under the trade name Steripaque has been introduced as a substitute for thorotrast in England. This non-radioactive particles can be phagocytized by macrophages of the abscess capsule and can be visualized well by X-ray.
We report a case of a huge subdural empyema in infant to whom we have treated with the use of Micropaque Barium Sulfate to figure out the exact location and the size of the abscess cavity.
7/12-year-old infant entered Seoul Red Cross Hospital with chief complaints of convulsive seizure, recurrent vomiting, large head size and conjugate deviation to the right eye balls.
The neurological findings were revealed that the large head size, budging of the fontanels, engorgement of veins on the scalp and conjugate. eye ball deviation to the right. The fundoscopic findings were within normal limits.
The subdural punctures on the great fontanel were carried out bilaterally and the yellowish-green colored pus was present in the left side.
The Micropaque Barium Sulfate was then injected into the abscess cavity and the skull X-ray was taken. This facilitated to see the exact extent of the abscess cavity and to drain the abscess, of which amount was over 100ce, through the two burr holes on the parietal and occipital region in the left. The suspension of sterilized Micropaque Barium Sulfate instilled again in the cavity during operation. The subsequent pus drainage was performed through the nelaton catheter for 5 days.
Postoperatively, all of the complaints and neurological deficits were disappeared.
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