Intracranial abscess after anterior skull base defect: does pneumocephalus play a role?

Intracranial complications of skull base defects are uncommon; however, they can be devastating when they do occur. Often these complications arise suddenly and without warning. Identifying patients at risk for intracranial abscesses may help with early diagnosis and allow for early interventions.

We report on 2 patients with traumatic pneumocephalus who developed intracranial abscesses. Our objective was to evaluate these cases and investigate the relationship between the presence of pneumocephalus and the formation of intracranial infection.

Data was reviewed on the cases of 2 patients who developed intracranial abscesses after pneumocephalus in the context of skull base defects.

Two patients presented to our institution separately with the presence of intracranial abscesses. Both patients had violation of their anterior skull base--one from endoscopic sinus surgery, one from blunt trauma. Both patients had massive pneumocephalus prior to their abscess formation.

Intracranial abscess formation, traumatic skull base defects, and massive pneumocephalus are uncommon entities, which may be associated. It may be prudent to have heightened suspicion for the presence of intracranial abscess formation in patients with massive pneumocephalus secondary to anterior skull base trauma.