case_images: PMC11786810_01
case_images: Clinical course timeline.
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case_images: PMC11786810_01_cureus-0017-00000076800-i01.jpg
case_images: FIG1
case_images: Figure 1 presents a timeline detailing this episode of care.
case_images: Contrast-enhanced brain MRI prior to surgery, demonstrating a thick-walled, peripherally enhancing, enlarging subdural collection overlying the right frontotemporal regions.
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case_images: PMC11786810_01_cureus-0017-00000076800-i02.jpg
case_images: FIG2
case_images: A contrast-enhanced brain MRI showed a thick-walled, peripherally enhancing, enlarging subdural collection overlying the right frontotemporal regions (Figure 2).
case_images: FLAIR sequence brain MRI, demonstrating the right temporal lobe hemorrhagic infarct with avid peripheral enhancement. . FLAIR: fluid-attenuated inversion recovery.
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case_images: PMC11786810_01_cureus-0017-00000076800-i03.jpg
case_images: FIG3
case_images: In addition, the right temporal lobe hemorrhagic infarct also showed an avid peripheral enhancement, further supporting the diagnosis of an abscess (Figure 3). Adjacent parenchymal edema, either inflammation or encephalitis, is best visualized on the fluid-attenuated inversion recovery (FLAIR) sequence (Figure 3).
case_images: Intraoperative exposure of SDE showing pressured gross pus draining from the subdural space upon anterior reflection of the dura flap.. SDE: subdural empyema.
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case_images: FIG4
case_images: As soon as the dural flap was reflected anteriorly, frank pus poured out under pressure from the subdural space (Figure 4). 