Intracranial Epidural Abscess and Pansinusitis in an Eleven Year Old boy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We reported a case of an 11-year-old boy with an intracranial epidural abscess and pansinusitis. He developed headache and fever and a diagnosis of sinusitis was made in the emergency room (ER). Two days later, the symptoms persisted and the right eye was swollen with tenderness around the right eyelids and fronto-temporal head. Cerebrospinal fluid (CSF) examination showed no abnormal values except for CSF pressure above 20 cmH20. Emergency enhanced brain computed tomography (CT) showed pansinusitis and small areas of air level density in the right frontal convexity. However, according to magnetic resonance imaging (MRI) the air level density lesion adjacent to the frontal sinusitis was an epidural abscess. Intravenous antibiotics were administered for 4 weeks without surgery, since the diameter of the abscess was 0.6 cm and follow up MRI showed noticeable improvement. His sinusitis and intracranial epidural abscess were completely resolved without sequelae at 6 weeks after medication. This report is a useful reference for cases of acute onset headache and may be helpful in diagnosis and treatment decisions for severe childhood sinusitis-related intracranial abscess.
Abstract
We reported a case of an 11-year-old boy with an intracranial epidural abscess and pansinusitis. He developed headache and fever and a diagnosis of sinusitis was made in the emergency room (ER). Two days later, the symptoms persisted and the right eye was swollen with tenderness around the right eyelids and fronto-temporal head. Cerebrospinal fluid (CSF) examination showed no abnormal values except for CSF pressure above 20 cmH20. Emergency enhanced brain computed tomography (CT) showed pansinusitis and small areas of air level density in the right frontal convexity. However, according to magnetic resonance imaging (MRI) the air level density lesion adjacent to the frontal sinusitis was an epidural abscess. Intravenous antibiotics were administered for 4 weeks without surgery, since the diameter of the abscess was 0.6 cm and follow up MRI showed noticeable improvement. His sinusitis and intracranial epidural abscess were completely resolved without sequelae at 6 weeks after medication. This report is a useful reference for cases of acute onset headache and may be helpful in diagnosis and treatment decisions for severe childhood sinusitis-related intracranial abscess.
참고문헌 (12)
- Pappas DE, "Nelson textbook of pediatrics", pp.1436~1438 (2011), WB Saunders Co
- Glickstein JS, "Intracranial complications of pediatric sinusitis", Otolaryngol Head Neck Surg, 134, pp.733~736 (2006)
- Kim BK, "Clinical manifestations of intracranial complication associated with paranasal sinus infection", J Korean Neurol Assoc, 19, pp.457~463 (2001)
- Heran NS, "Conservative neurosurgical management of intracranial epidural abscesses in children", Neurosurgery, 53, pp.893~897 (2003)
- Mauser HW, "Neurosurgical treatment of subdural empyema", J Neurosurg, 63, pp.128~130 (1985)
- Obana WG, "Nonoperative treatment of neurosurgical infections", Neurosurg Clin N Am, 3, pp.359~373 (1992)
- Singh B, "Sinogenic intracranial complications", J Laryngol Otol, 109, pp.945~950 (1995)
- Wald ER, "Microbiology of acute and chronic sinusitis in children and adult", Am J Med Sci, 316, pp.13~20 (1998)
- Skelton R, "Sinusitis induced subdural empyema", Arch Dis Child, 67, pp.1478~1480 (1992)
- Johnson DL, "Treatment of intracranial abscess associated with sinusitis in children and aldorescents", J Pediatr, 113(1 Pt 1), pp.15~23 (1998)
- Deutschmann MW, "The significance of streptococcus anginosus group in intracranial complications of pediatric rhinosinusitis", JAMA Otolaryngol Head Neck Surg, 139, pp.157~160 (2013)
- Atmaca S, "Rhinolithiasis, an unusual cause of sinusitis complicated with frontal osteomyelitis and epidural abscess", Turk J Pediatr, 52, pp.187~190 (2010)