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[Pseudotumor cerebri associated with maxillary sinusitis: clinico-pathological study].

A García-Pérez1, M Espino, A Barrio

  • 1Unidad de Pediatría, Fundación Hospital Alcorcón, Madrid, España. agarcia@fhalcorcon.es

Revista De Neurologia
|August 19, 2000
PubMed
Summary

Pseudotumor cerebri, a condition of increased intracranial pressure, was linked to maxillary sinusitis in a pediatric case. Prompt treatment resolved symptoms, suggesting a potential link between ENT infections and this neurological disorder.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Pseudotumor cerebri (PTC) involves elevated intracranial pressure (ICP) without identifiable lesions or cerebrospinal fluid (CSF) circulation obstruction.
  • Diagnostic criteria for PTC include increased ICP with normal CSF composition.
  • Sinusitis and ear infections are rarely implicated as potential causes of PTC.

Observation:

  • A 12-year-old girl presented with diplopia and VI cranial nerve palsy following sinusitis treatment.
  • Examination revealed bilateral papilledema, enlarged blind spots, and maxillary sinusitis on resonance imaging.
  • Cerebrospinal fluid (CSF) analysis showed elevated pressure (35 cm H2O) with mild lymphomonocytic pleocytosis.

Findings:

  • The patient received acetazolamide, dexamethasone, and cefotaxime after CSF removal.

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  • Diplopia resolved within a week, and CSF pressure normalized (25 cm H2O) with no cells.
  • Ophthalmological findings and visual fields returned to normal within two months, with no recurrence over one year.
  • Implications:

    • This case suggests a potential association between PTC and maxillary sinusitis.
    • The initial CSF pleocytosis may indicate an infectious or para-infectious process, possibly related to CSF reabsorption interference.
    • Considering ENT infections as a potential trigger for PTC is crucial for timely diagnosis and management.