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Non-Traumatic Pneumocephalus and Sub-Dural Empyema as a Complication of Chronic Sinusitis

Sidra Saleem1, Arsalan Anwar2, Hobab Aslam3

  • 1Neurology, University of Toledo, Toledo, USA.

Cureus
|October 1, 2019
PubMed

Insights

Pediatric infectious sinusitis can cause dangerous intracranial complications. This case highlights pneumocephalus and subdural empyema, emphasizing diagnostic challenges and the need for prompt imaging and treatment to prevent severe outcomes.

Area of Science:

  • Pediatric infectious diseases
  • Neurology
  • Radiology

Background:

  • Infectious sinusitis is common in children, with potential for severe intracranial complications.
  • Intracranial complications include meningitis, cerebral abscess, and pneumocephalus.
  • Pneumocephalus, air in the cranium, can lead to infection and pus collection.

Observation:

  • A 12-year-old girl presented with confusion and disorientation.
  • Cerebrospinal fluid analysis suggested bacterial meningitis.
  • CT scan revealed pneumocephalus and subdural empyema.

Findings:

  • Pneumocephalus, the presence of air in the cranium, can be associated with intracranial infection.
  • Subdural empyema is a collection of pus between the dura mater and arachnoid mater.
  • This case illustrates the diagnostic challenge of co-occurring pneumocephalus and subdural empyema in a pediatric patient with sinusitis.

Implications:

  • Accurate and timely diagnosis using advanced imaging is crucial for managing these rare complications.
  • Appropriate treatment strategies are essential to prevent long-term neurological sequelae.
  • This case report aids clinicians in recognizing and managing challenging intracranial complications of sinusitis.

Keywords:
chronic sinusitisintracranial complicationspneumocephalussubdural empyema

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