Infratentorial Subdural Empyema, Pituitary Abscess, and Septic Cavernous Sinus Thrombophlebitis Secondary to Paranasal Sinusitis: Case Report

Sahjpaul, Ramesh; Lee, Donald H.

doi:10.1097/00006123-199904000-00101

Cited by 45 publications

(28 citation statements)

References 15 publications

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“…However, majority of adenomas will have more solid enhancement as opposed to thin rim in case of an abscess [14]. Presence of air fluid level, meningeal enhancement, cerebritis, sphenoid sinus effusion or destruction of its floor, absence of posterior pituitary bright spot, cavernous sinus thrombosis are supportive towards an abscess [15,16].…”

Section: Discussionmentioning

confidence: 99%

Pituitary abscess: Report of four cases and review of literature

et al. 2006

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Pituitary abscess is a rare disorder and its presenting manfestations are non-specific therefore, the diagnosis is usually made either postoperatively or at postmortem. We describe four such cases seen over a period of 10 years. All the patients presented with fever, systemic signs of toxaemia and endocrine dysfunctions. Two of them had pre-existing pituitary pathology. A preoperative diagnosis of pituitary abscess was considered in all in view of characteristic MR findings. Three patients underwent transsphenoidal drainage of abscess, whereas the remaining one succumbed to sepsis and was diagnosed at necropsy. Offending organisms including Pseudomonas, Acinetobacter and Staphylococcus were isolated in three cases respectively. During follow-up for 4 years, 2 patients are doing well, one had a recurrent abscess after 1 year and required redo-surgery.

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Section: Discussionmentioning

confidence: 99%

Pituitary abscess: Report of four cases and review of literature

et al. 2006

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“…A previous case of three different intracranial extensions (infratentorial empyema, pituitary abscess, and septic cavernous sinus thrombophlebitis) secondary to paranasal sinusitis showed septic cavernous sinus thrombophlebitis extended to the clivus. 19) Orbital SPA and intracranial extension from paranasal sinusitis has not been reported. This complicated pathogenesis made the diagnosis very difficult in our case.…”

Section: Discussionmentioning

confidence: 99%

Clival Inflammation With Cavernous Sinus Thrombophlebitis and Orbital Subperiosteal Abscess -Case Report-

Nakamura

Kawamata

Kobayashi

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 64-year-old woman presented with a very rare case of three infectious lesions, cavernous sinus thrombophlebitis, clival inflammation, and orbital subperiosteal abscess (SPA), manifesting as abducens palsy. An isolated non-specific mass in upper clivus was initially suspected to be derived from paranasal sinusitis. The clival lesion was approached by an endonasal transsphenoidal route and diagnosed as inflammation. However, progressive enlargement of an orbital mass was recognized, with eyelid erythema and swelling. Magnetic resonance imaging showed massive paranasal sinusitis and an intra-orbital mass, which was proved to be an orbital SPA by open surgery. Cavernous sinus thrombophlebitis might have been caused by primary paranasal sinusitis, and the origin of orbital cellulitis was suspected to be cavernous sinusitis based on the preoperative radiological findings. These unusual lesions should be kept in mind as one of the differential diagnoses.

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“…In 1993, Bok and Peter [6] conducted a retrospective study of 90 cases with subdural empyema and found 34 and 4 cases, respectively, located at the interhemispheric (37%) and posterior fossa (4%), whereas the case series reported by Nathoo et al [13] found that only 1 patient (0.5%) developed infratentorial empyema secondary to paranasal sinusitis. In 1999, Sahjpaul and Lee [14] also described a case of infratentorial subdural empyema secondary to paranasal sinusitis with pituitary abscess and septic cavernous sinus thrombophlebitis. Our patient suffered subdural empyema located in the interhemispheric and infratentorial regions.…”

Section: Discussionmentioning

confidence: 99%

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

et al. 2017

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Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.

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Infratentorial Subdural Empyema, Pituitary Abscess, and Septic Cavernous Sinus Thrombophlebitis Secondary to Paranasal Sinusitis: Case Report

Cited by 45 publications

References 15 publications

Pituitary abscess: Report of four cases and review of literature

Pituitary abscess: Report of four cases and review of literature

Clival Inflammation With Cavernous Sinus Thrombophlebitis and Orbital Subperiosteal Abscess -Case Report-

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

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