[A case of subclinical frontal lobe abscess as a complication of sinusitis]

Nowadays suppurative complications of sinusitis are uncommon in orderto widespread treatment with antibiotics. Intracranial complications include bacterial meningitis, encephalitis, brain abscess, epidural or subdural abscess and sinus thrombophlebitis.The 13-40% of all brain abscesses are sinogenic complications. The inflammation process spreads from sinuses by valveless diploic veins of the skull as thrombophlebitis or by direct extension of osteomyelitis. Jatrogenic, posttraumatic or natural fissures in bony walls can also take part in spreading the infection. Diagnostic process includes laryngological and neurological evaluation with the computer tomography scanning or magnetic resonance imaging. Patients with intracranial complications require broad-spectrum antibiotic therapy and surgical treatment in orderto remove the origin of infection in the sinuses. For physicians they are always challenging conditions according to their significantly high mortality. The case of the 24 year old patient with sinogenic brain abscess was shown in this paper. He neglected ambulatory treatment of chronic sinusitis because of lack of the medical insurance. After episode of losing the consciousness he was admitted to the ENT Department with headache, nausea, fever and dehydration. The diagnose was established based on laryngological and neurological examination and visualization of brain abscess on CT scans. He was treated by surgical intervention conducted by team of head and neck surgeons and neurosurgeons. Intensive antibiotic therapy with the Uffenorde operation of frontal sinuses and neurosurgical removal of the brain abscess was performed.The epidemiology, clinical course, diagnostic problems and therapy were described.