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A Rare Case of Occipital Subdural Abscess of Rhinogenic Origin: Case Report

Sudhakara Madala1,2, Devi Amulya Pilli1,3, Anusha Akkineni1

  • 1Departement of ENT, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Gannavaram, India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|June 5, 2023
PubMed

Insights

A rare case of brain abscess secondary to frontal sinusitis highlights the potential for serious intracranial complications despite antibiotic use. Prompt diagnosis and surgical intervention are crucial for managing these life-threatening conditions.

Area of Science:

  • Neurology
  • Otolaryngology
  • Infectious Diseases

Background:

  • Sinusitis complications are rare but can be life-threatening due to inadequate antibiotic treatment.
  • Masked symptoms from insufficient antibiotic therapy can lead to severe morbidity and mortality.

Purpose of the Study:

  • To report a rare case of a parafalcine abscess in the left occipital lobe secondary to frontal sinusitis.
  • To emphasize the importance of recognizing and managing intracranial complications of sinusitis.

Main Methods:

  • A 40-year-old male presented with fever, headache, neck stiffness, and altered sensorium.
  • Initial CT revealed extensive sinusitis; conservative treatment yielded partial improvement.
  • Repeat CT identified a left occipital lobe abscess, treated with neurosurgical aspiration and endoscopic sinus surgery (ESS).

Main Results:

  • A parafalcine abscess in the left occipital lobe was diagnosed.
  • Neurosurgical aspiration of the abscess was performed.
  • Endoscopic sinus surgery (ESS) cleared the frontal sinus to prevent recurrence.

Conclusions:

  • Intracranial complications of sinusitis, though rare, remain a significant concern.
  • Early diagnosis and multidisciplinary management involving neurosurgery and ENT are vital.
  • Aggressive surgical clearance of sinuses is necessary to prevent recurrent intracranial infections.
Keywords:
DRAF IIFrontal sinusitisOccipital lobeParasagittal abscess

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