Identifying and Managing Intracranial Complications of Sinusitis in Children

• DOI: 10.1097/inf.0b013e3181f86398
• Publication Date: 2010-10-05T09:18:59Z
• Authors: Caitlin W. Hicks; Joseph G. Weber; Janet R. Reid; Manikum Moodley
• Keywords: Brain abscess; Subdural empyema

Of patients admitted to hospital with sinusitis, about 3% have an intracranial complication. We describe the clinical features, laboratory data, imaging findings, and outcomes of pediatric complications sinusitis.A retrospective chart review all < 21 years age for sinusitis a tertiary over 10-year period.A total 13 mean 13.3 ± 3.7 presented headache (92%), fever (85%), nausea/vomiting (62%), sinus tenderness (31%), lethargy (23%). Physical examination findings included Pott puffy tumor (46%), orbital cellulitis altered level consciousness new-onset seizure hemiparesis (23%), nuchal rigidity visual disturbance slurred speech (15%). Computed tomography magnetic resonance demonstrated 16 instances epidural subdural empyema, 1 brain abscess. One child had sagittal thrombosis.Our suggest that acute in combination severe intractable headache, varying degrees consciousness, focal neurologic deficits, and/or signs meningeal irritation should raise suspicion potential sinusitis. These symptoms prompt early aggressive evaluation management, including neuroimaging studies, otolaryngologic consultations, intravenous antibiotics.