Objective    To investigate the role of subdural puncture (SDP) in the diagnosis and treatment of subdural fluid collection in young children with purulent meningitis.     Methods    Totally 207 2-year-old children with diagnosed purulent meningitis were collected and reviewed. Their incidence of subdural fluid collection were evaluated with SDP

ultrasonography

computerized tomography (CT) scanning or magnetic resonance imaging (MRI). The identified collection was released subsequently or treated by placing a subdural drain whenever the collection was either clinically eloquent or exerted a mass effect on the brain.     Results    There were 42 patients found subdural fluid collection in the 207 children. Among them

33 cases (79%) were confirmed with imaging techniques (14

25 or 4 children by ultrasonography

CT or MRI)

but the other 9 cases (21%) were not found by them but only by SDP. The final diagnosis of these subdural fluid collection patients was made based on SDP. No any other surgery other than SDP was performed in 33 patients who were recovery later because the fluid collection was small or did not recur after SDP. Among the 7 patients requiring placement of a subdural drain

one infant underwent craniectomy and membrane resection

and 6 patients were recovered except one abandoned treatment because of family economy.     Conclusion    SDP plays an important role in the diagnosis and treatment of subdural fluid collection in young children after purulent meningitis.