A subdural aspiration is performed for diagnostic purposes as well as for rapid decompression of subdural fluid collections, whether acute or chronic. Perform a subdural aspiration in the young child with a subdural fluid collection and radiographic signs of elevated intracranial pressure, a depressed level of consciousness, and/or a changing level of consciousness.5 Other indications to perform a subdural aspiration include the clinical signs and symptoms associated with elevated intracranial pressure: bulging fontanelles, coma, cranial nerve palsies, hemiparesis, hypotonia, irritability, lethargy, posturing, seizures, somnolence, and vomiting (repeated or intractable). Aspiration of extra-axial fluid collections can reduce intracranial pressure dramatically. Subdural aspiration of fluid allows for culture and sensitivity, identification of microorganisms, and aids in the selection of bacterial specific antimicrobial agents if an infectious etiology is considered to be the cause of the extra-axial fluid collection.