Pediatric Sinogenic Subdural Empyema: Case Report and Operative Technique.

Area of Science:

• Pediatric Neurology
• Neurosurgery
• Otolaryngology

Background:

• Intracranial complications of sinusitis are rare but life-threatening in children.
• Nonspecific symptoms like headache and fever can mask serious neurological conditions.
• Early diagnosis and prompt treatment are essential to prevent severe morbidity and mortality.

Purpose of the Study:

• To report a case of sinogenic subdural empyema in an immunocompetent child.
• To describe the diagnostic process and management of this rare complication.
• To emphasize the importance of multidisciplinary care in pediatric sinusitis complications.

Main Methods:

• Case report of a young boy with sinogenic subdural empyema.
• Initial assessment included laboratory tests, neurological and ENT evaluations, and CT scan.
• Diagnosis confirmed by MRI, followed by surgical drainage (craniotomy and endoscopic) and antibiotic therapy.

Main Results:

• The patient presented with headache, initially treated with antibiotics.
• Sudden neurological deterioration prompted MRI, revealing subdural empyema and midline shift.
• Combined surgical and medical treatment led to full neurological recovery without deficits.

Conclusions:

• Subdural empyema is a severe complication of pediatric sinusitis requiring urgent intervention.
• Multidisciplinary approach involving neurosurgery and ENT is key for successful outcomes.
• Early recognition and prompt, combined therapy significantly reduce morbidity and mortality.