Subdural Empyema Complicating Sinusitis

Waseem, Muhammad; Khan, Saqiba; Bomann, Scott

doi:10.1016/j.jemermed.2007.07.019

Cited by 31 publications

(18 citation statements)

References 35 publications

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“…These lesions progress rapidly and cause increased intracranial pressure leading to coma and death within 24 to 48 hours if untreated 2,3. Historically, these rare complications occurred secondary to otitis media, but currently they are seen more frequently as a complication of bacterial sinusitis 4.…”

Section: Discussionmentioning

confidence: 99%

“…Subdural empyemas present most commonly in the second and third decades of life 3. While they can have a wide variety of symptoms, fever and progressive headache are the most common 2. Some patients do not have a known history of sinus disease, and others may have chronic or subacute sinusitis which can confound the clinical diagnosis further.…”

Section: Discussionmentioning

confidence: 99%

“…3,8,12 Interventions to lower intracranial pressure (elevation of the head of the bed, mannitol, and ventriculostomy) should be performed as necessary. Emergent neurosurgical consultation is paramount as surgical intervention (burr hole or craniotomy) is necessary in most cases to provide the best opportunity at neurologic recovery 2. Likewise, otolaryngologic consultation is recommended because functional endoscopic sinus surgery (FESS) may aid in drainage and recovery 5,8.…”

Section: Discussionmentioning

confidence: 99%

“…Intracranial suppurative lesions are life-threatening surgical emergencies that are rarely seen, difficult to diagnose, and can have serious long-term morbidity if not diagnosed and managed promptly and appropriately 1,2. When present, these lesions are found often in adolescents and can present with non-specific symptoms of fever and headache.…”

Section: Introductionmentioning

confidence: 99%

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Subdural Empyema Presenting with Seizure, Confusion, and Focal Weakness

Bruner¹,

Littlejohn²,

Pritchard³

2012

WestJEM

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While sinusitis is a common ailment, intracranial suppurative complications of sinusitis are rare and difficult to diagnose and treat. The morbidity and mortality of intracranial complications of sinusitis have decreased significantly since the advent of antibiotics, but diseases such as subdural empyemas and intracranial abscesses still occur, and they require prompt diagnosis, treatment, and often surgical drainage to prevent death or long-term neurologic sequelae. We present a case of an immunocompetent adolescent male with a subdural empyema who presented with seizures, confusion, and focal arm weakness after a bout of sinusitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subdural Empyema Presenting with Seizure, Confusion, and Focal Weakness

Bruner¹,

Littlejohn²,

Pritchard³

2012

WestJEM

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“…5,6 Subdural empyema is the most common intracranial complication of sinusitis and is a rapidly developing neurosurgical emergency with surgical indication that leads to increased intracranial pressure and can cause coma and death within 24 to 48 hours if left untreated. 2,3,7 The development of intracranial complications with sinusitis can be caused by direct extension or retrograde thrombophlebitis resulting from capless diploe veins. Retrograde thrombophlebitis originates from associated venous drainage of the paranasal sinuses and intracranial structures.…”

Section: Case Reportmentioning

confidence: 99%

Subdural empyema as a rare complication of sinonasal infection: a case report and review of literature

et al. 2017

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Subdural empyema is a rare complication that causes high morbidity and mortality following sinusitis. Cranial complications should be considered in patients who develop neurological symptoms. These patients need surgery that should be performed by neurological and ear-nose-throat surgeons working together. A 14-year-old girl developed aphasia and hemiparesis from retrograde thrombophlebitis following sinusitis and we planned a two-stage surgery for the patient. In the first step, we drained the empyema by a craniotomy and functional endoscopic sinus surgery. In the second step, we drained a mature abscess. The purpose of this paper is to review the surgical and clinical management of intracranial complications from sinonasal infections.

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