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Sinogenic intracranial empyema in children
Noemi Adame1, Gary Hedlund, Carrie L Byington
1Department of Pediatrics, Primary Children's Medical Center, University of Utah, Salt Lake City, Utah, USA. adamen@uthscsa.edu
Pediatrics
|September 6, 2005
Summary
Sinogenic intracranial empyema (SIE) in children presents with neurological symptoms and elevated inflammatory markers like ESR and CRP. Early diagnosis using contrast-enhanced MRI or CT is crucial for effective management.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Radiology
Background:
- Sinogenic intracranial empyema (SIE) is a rare but severe complication of sinusitis in children.
- Prompt recognition and management are vital to prevent serious neurological damage.
Purpose of the Study:
- To detail the clinical presentation, diagnostic findings, and outcomes of pediatric SIE cases.
- To compare inflammatory markers in children with SIE versus uncomplicated sinusitis.
Main Methods:
- Retrospective cohort study of 12 children with SIE.
- Comparison of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels with 142 children with uncomplicated sinusitis.
- Review of imaging studies including CT and MRI.
Main Results:
- Common symptoms included headache, fever, and altered mental status; signs included abnormal neurologic exams and orbital findings.
- Children with SIE showed significantly higher CRP and ESR levels compared to controls.
- Contrast-enhanced MRI or CT accurately diagnosed SIE, while non-enhanced CT was less sensitive.
Conclusions:
- Neurological symptoms, complicated sinusitis signs, or persistent symptoms warrant evaluation for SIE.
- Elevated ESR and CRP levels can serve as useful screening markers.
- Contrast-enhanced MRI is the preferred imaging modality for diagnosing SIE in children.