Bilateral subdural empyemas with meningitis secondary to acute barosinusitis - 10/11/18

Doi : 10.1016/j.anorl.2018.03.006

J. Sung, O. Kwon, D. Kim, K. Kim ^⁎
Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 50 Seongan-ro, 05355 Gangdong-gu, Seoul, Korea

^⁎Corresponding author.

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Abstract

Introduction

Intracranial complications of acute rhinosinusitis are rare, but may turn life-threatening.

Case summary

We report a healthy 30-year-old male who complained of frontal headache, which developed while on a plane. A brain CT showed a low-density lesion on the left frontal convexity with right maxillary and ethmoid sinusitis. Despite receiving intravenous antibiotics, a follow-up brain CT showed two lesions with adjacent dural and leptomeningeal enhancement. A paranasal sinus CT revealed aggravated left frontal sinusitis and right maxillary sinusitis. The patient underwent craniotomy and brain abscess removal along with endoscopic sinus surgery. Seventeen days after the surgery, the patient was discharged with no neurological sequelae.

Conclusion

To the best of our knowledge, this case is the first report regarding the association between barotrauma and intracranial complications of acute rhinosinusitis. A high index of suspicion and well-timed surgical evacuation may ensure a full recovery.

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Keywords : Frontal sinusitis, Subdural empyema, Barotrauma, Meningitis