title: [Subdural empyema complicating sinusitis].
abstract: Paranasal sinusitis complicated by subdural empyema (SDE) in a 14-year-old boy is described. He presented with fever, headache and vomiting. X-rays revealed left maxillary and bilateral frontal sinusitis. While in the emergency room he had seizures; CT-scan showed an air leak adjacent to the right frontal sinus. Despite intravenous antibiotics, left hemiparesis developed and repeat CT showed interhemispheric SDE. Frontal craniotomy was performed and a large amount of purulent material was drained. Recovery followed 4 weeks of intravenous antibiotic treatment without neurologic sequelae. SDE is a rare complication of paranasal sinusitis and constitutes approximately 20% of all localized intracranial infections. Clinical features include fever, headache, vomiting, convulsions and neurologic deficits. Modern imaging methods and combined surgical and antibiotic treatment have lowered mortality to 5-10%. A high index of suspicion is important for early diagnosis and successful treatment.
authors.affiliation: Medical Corps, Israel Defence Forces.
authors.forename: E
authors.initials: E
authors.lastname: Saiag
authors.forename: D
authors.initials: D
authors.lastname: Steir
authors.forename: M
authors.initials: M
authors.lastname: Michowitz
authors.forename: G
authors.initials: G
authors.lastname: Horev
authors.forename: B
authors.initials: B
authors.lastname: Garty
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013354:Empyema, Subdural / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D012852:Sinusitis / Q000150:complications*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents