Intracranial subdural empyema in intravenous drug users – A rarest complication

In intracranial drug users (IVDU), there are case reports of spinal subdural empyema. However, there is single case report of intracranial subdural empyema in IVDU. Why is it rare? We report second case and its analysis pertaining to our case. Case Description: a 26‑years male, chronic IV drug abuser of impure opium («Chitta»), HCV positive, presented with altered sensorium. CT head revealed subdural collection right side with 11 mm shift. We did right side hemicraniotomy and evacuated pus. Postoperatively he recovered well. Conclusions – Subdural empyema can occur due to bacteremia, infective endocarditis. In IVDU, presence of HCV infection may predispose to intracranial subdural empyema.