Klinisch denken en beslissen in de praktijk. Een student met plotselinge hoofdpijn

Translated title of the contribution: Clinical thinking and decision making in practice. A student with sudden headache

R Saxena, W P Vandertop, G L Küppers, J C van Swieten

Research output: Contribution to journalArticleAcademicpeer-review


A previously healthy man aged 18 years suddenly developed a severe headache, followed by nausea, vomiting, fever. During the following weeks a left-sided hemiparesis developed. CT of the brain revealed a pansinusitis and a frontal epidural empyema. A few days after surgical drainage his condition deteriorated and subsequent CT showed a right-sided subdural empyema. This was surgically evacuated and followed by long-term high-dose intravenous antibiotic therapy. The patient made a complete recovery. A sudden severe headache can be caused by an intracranial infection and intracranial pus collections can occur in the subdural as well as in the epidural space. Epidural empyema is a limited disease with relatively mild symptoms and a favourable prognosis, whereas subdural empyema may rapidly spread and cause severe disease with a poor prognosis. Quick antibiotic treatment and surgical drainage are required.

Translated title of the contributionClinical thinking and decision making in practice. A student with sudden headache
Original languageDutch
Pages (from-to)741-5
Number of pages5
JournalNederlands Tijdschrift voor Geneeskunde
Issue number16
Publication statusPublished - 15 Apr 2000

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