Pediatric sinogenic intracranial abscesses: a case series and literature review

Acute and chronic sinusitis in pediatric patients can lead to a variety of intracranial complications, such as intracranial abscesses (brain abscess, subdural empyema, and epidural abscess), meningitis, and venous sinus thrombosis, which are associated with significant morbidity and mortality. This study aims to improve clinical awareness of pediatric sinogenic intracranial abscesses through case presentations and a literature review.

We retrospectively analyzed three pediatric cases (10-13 years old) with sinogenic intracranial abscesses treated at our institution between 2024 and 2025. Demographic, clinical, radiological, and operative data were extracted from medical records and imaging studies. A review of relevant literature was also performed to summarize key insights into the pathophysiology, clinical manifestations, diagnosis, and management of this condition.

Two girls and one boy were included in the study. All three patients presented with key symptoms of headache and fever. Cranial imaging confirmed intracranial purulent collections (epidural abscess or subdural empyema) secondary to sinusitis. All received intravenous antibiotic therapy, and two underwent combined neurosurgical and otolaryngological interventions. All achieved an uneventful recovery and were discharged without severe sequelae. The literature review identified Streptococcus species as the primary pathogens, with frontal and ethmoid sinus involvement being most common. Concurrent neurosurgical and otolaryngological intervention is recommended to optimize treatment outcomes.

Pediatric sinogenic intracranial abscesses demand early recognition through integrated clinical and radiological assessment. Multimodal treatment including targeted antibiotics and timely surgical intervention is critical to improving outcomes and minimizing neurological sequelae.