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Identifying and managing intracranial complications of sinusitis in children: a retrospective series

Caitlin W Hicks1, Joseph G Weber, Janet R Reid

  • 1Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.

The Pediatric Infectious Disease Journal
|March 19, 2011
PubMed

Insights

Intracranial complications of sinusitis are rare but serious in children. Early recognition of symptoms like severe headache and altered consciousness is crucial for prompt diagnosis and treatment.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Intracranial complications arise in approximately 3% of hospital admissions for sinusitis.
  • This study focuses on pediatric patients experiencing these severe complications.

Purpose of the Study:

  • To delineate the clinical features, diagnostic findings, and outcomes of pediatric intracranial complications secondary to sinusitis.
  • To enhance early detection and management strategies for this rare but severe condition.

Main Methods:

  • Retrospective chart review of pediatric patients (<21 years) admitted for intracranial complications of sinusitis over a 10-year period.
  • Analysis of clinical presentations, laboratory data, neuroimaging results, and treatment outcomes.

Main Results:

  • Thirteen pediatric patients presented with symptoms including headache (92%), fever (85%), and altered consciousness (46%).
  • Common findings included Pott puffy tumor (46%) and orbital cellulitis (46%).
  • Neuroimaging revealed epidural/subdural empyema (16 instances), brain abscess (1), and sagittal sinus thrombosis (1).

Conclusions:

  • Severe headache, altered consciousness, focal neurological deficits, or meningeal irritation in sinusitis patients warrants suspicion for intracranial complications.
  • Prompt neuroimaging, specialist consultations, and aggressive antibiotic therapy are essential for optimal management.
Abstract

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