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Intracranial complications of sinusitis: the need for aggressive management

Published online by Cambridge University Press:  29 June 2007

R. L. Jones
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
N. S. Violaris
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
S. V. Chavda
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
A. L. Pahor*
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
*
Mr A. L. Pahor, Department of Otorhinolaryngology, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QH.

Abstract

Sinus-induced intracranial sepsis can represent a genuine medical and surgical emergency. We review 12 cases presenting to our hospitals over a five-year period. Nine were male and three were female with an age range of 16 to 74 years (mean 35.5 years). Four patients had their sinusitis diagnosed prior to admission and eight did not. Nine patients had bilateral sinus disease, the most common sinus involved was the frontal followed by the ethmoid, maxillary and sphenoid. Neurosurgical drainage was via a craniotomy in seven cases and burr hole in three. Nine patients underwent sinus surgery and three did not. Of the nine who had sinus surgery three had frontal drainage, four fronto-ethmoidal and two transsphenoidal drainage. The most common organism was Streptococcus milleri. Our series confirms that sinus-induced intracranial sepsis is a serious problem needing early diagnosis and aggressive treatment. We would recommend a high index of suspicion of sinusitis in patients with intracranial infection.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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Footnotes

Presented at the 15th Congress of the European Rhinology Society (Copenhagen) June 1994.

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