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Intractable headache: aseptic meningitis and sphenoidal sinusitis

S D Silberstein1

  • 1Temple University School of Medicine, Germantown Hospital and Medical Center, Philadelphia.

Cephalalgia : an International Journal of Headache
|October 1, 1994
PubMed
Summary
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Sphenoid sinusitis, though rare, can cause severe headaches and aseptic meningitis. Prompt diagnosis and intravenous antibiotic treatment are crucial for resolving this serious sinus infection.

Area of Science:

  • Neurology
  • Otolaryngology
  • Infectious Diseases

Background:

  • Sphenoid sinusitis is an uncommon but serious condition.
  • It can present with severe, intractable headaches.
  • Associated morbidity can be significant if undiagnosed.

Observation:

  • A 30-year-old male presented with progressive intractable headache.
  • The patient also exhibited symptoms of aseptic meningitis.
  • Initial brain CT scans failed to identify the sphenoid sinus disease.

Findings:

  • Delayed diagnosis due to misinterpretation of imaging.
  • The underlying cause was identified as sphenoid sinusitis.
  • Intravenous antibiotic therapy led to complete resolution of symptoms.

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Implications:

  • Highlights the importance of considering sphenoid sinusitis in headache differential diagnoses.
  • Emphasizes the need for thorough evaluation of the sphenoid sinuses in complex headache cases.
  • Underscores the effectiveness of timely antibiotic treatment for sphenoid sinusitis-induced meningitis.