Intracranial complication of sinusitis in a 18-year old patient
Piotrowski, S.; Wojciechowski, I.; Zaniewska-Kulesza, I.; Bojarski, P.
Otolaryngologia Polska 54(2): 177-180
2000
ISSN/ISBN: 0030-6657 PMID: 10961078 Document Number: 518672
We have described a case of intracranial complications, which were caused by acute inflammation of maxillary sinus. In our patient we observed the development of multilocular intracranial abscesses located in left temporal lobe. However intracranial complications of sinusitis are rare, but they are still a serious problem that results in high mortality. The dominant features were: nighttime headache, fever, amnestic aphasia. The patient was treated surgically--utilizing traditional operation Caldwell-Luce'a. A conservative treatment was administrated during a long period including high-doses of i.v. antibiotics. This kind of patients require an interdisciplinary approach--radiological, neurosurgical and otolaryngological. The diagnosis was made with the aid of X-ray, CT-scan and cerebrospinal fluid examination. In spite of very intensive treatment the patient was unconscious one week. Her condition improved in the third week of her admission. CT-scanning carried out in first week showed brain infection. Repetition of Ct-scans of the head evidenced progression of disease by forming multiple abscesses in left temporal lobe excluding any neurosurgical treatment. Finally the patient's condition improved in the third week of her admission. She was discharged after six weeks of treatment without cranial nerve palsies. Amnestic aphasia lasted next six months.