Subdural empyema of sinus origin in children

Two children with subdural empyema of paranasal sinus origin presented as neurological emergencies. Both had severe acute pansinusitis with complicating subdural empyema. The need for a high index of suspicion in the proper clinical setting is mandatory even in the absence of confirmatory contrast studies. Surgical proof should be immediately followed by adequate treatment. The high mortality rate even in the antibiotic area calls for this approach.