Abstract
Background: Intracranial infectious suppurative lesions are serious and life-threatening conditions that are difficult to diagnose. Contrast-enhanced CT scan is the gold standard method For the diagnosis of subdural empyema. The two most surgical procedures that have been conducted for SDE are craniotomy and burr holes.
This study aims to present the advantages of bone flab in the management of acute subdural empyema based on our institution's experience.
Methods: This is a retrospective study conducted at Benha university, Department of neurosurgery. The study duration was from January 2019 to December 2020.
Results: There were 9 males and 24 females, with ages ranging from 6 months to 12 years (mean 9 years). Their mean hospital stay was 11 days. The surgical approaches used in this work were burr holes in 12 out of 33 patients while in 21 patients we did full wide craniotomy. The size of the evacuated empyema ranged from 40 to 80 cc calculated by the radiology specialist as it couldn't be collected and measured intraoperatively.
Conclusion: Empyema is a medical emergency that mandates urgent surgical evacuation. Craniotomy may have superiority over burr hole evacuation to prevent residual or recurrence.

Keywords: bone flab, Intracerebral suppurative infections, acute subdural empyema.
Corresponding author: Mohammed Mourad, Department of Neurosurgery, Benha University; Egypt. Tel: (+2)01558445071. email: morademan@yahoo.de.