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Abstract:
In 17 cases of sinusitis-induced subdural empyema, all but 5 occurred in boys or men aged 13 to 33 years. Clinical features were headaches and fever (14 patients), nuchal rigidity (10), and seizures (8). Seven patients had periorbital cellulitis, and 15 had radiographic clouding of at least one sinus. Only five patients had a history of sinusitis. CT identified the empyema accurately in seven patients but failed in two patients who developed subdural empyema while being treated for sinusitis-induced cerebritis. Ten patients had specific bacteriologic etiologies determined by culture of empyema, blood, or sinuses.
Insights
Sinusitis can lead to subdural empyema, a serious brain infection, primarily affecting young males. Early diagnosis and treatment are crucial for better outcomes in these rare but severe cases.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Subdural empyema is a rare but life-threatening complication of sinusitis.
- Prompt recognition and management are critical for patient survival and neurological recovery.
Purpose of the Study:
- To analyze the clinical characteristics, diagnostic challenges, and etiologies of sinusitis-induced subdural empyema.
- To highlight the importance of advanced imaging in diagnosing this condition.
Main Methods:
- Retrospective case series analysis of 17 patients with sinusitis-induced subdural empyema.
- Review of clinical presentations, radiographic findings (including CT scans), and microbiological data.
Main Results:
- The majority of cases (12/17) occurred in males aged 13-33 years.
- Common symptoms included headache, fever, nuchal rigidity, and seizures.
- Radiographic sinus clouding was present in 15 patients; CT accurately diagnosed empyema in 7/9 evaluated cases.
- Bacteriologic etiology was identified in 10 patients.
Conclusions:
- Sinusitis-induced subdural empyema predominantly affects young males and presents with diverse neurological symptoms.
- CT imaging is valuable but can be limited in cases with concurrent cerebritis.
- Identifying specific bacterial pathogens is essential for targeted antimicrobial therapy.