CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2017 August;1(2):68-72

DOI: 10.23736/S2532-3466.17.00118-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Subdural empyema secondary to frontal sinusitis in an adult female

Fabio COSTA ¹ ✉, Francesco TUNIZ ², Massimo ROBIONY ¹

¹ Maxillofacial Surgery Unit, Udine University Hospital, Udine, Italy; ² Neurosurgery Unit, Udine University Hospital, Udine, Italy

Intracranial complications caused by sinusitis in adult female are extremely rare. A 46-year-old Caucasian woman with a history of sinusitis developed lethargy, headache, rhinorrhea and fever. Computed tomography scan (CT) demonstrated pansinusitis, small parietal fluid collection with erosion of the posterior table of the frontal sinus on the left side. She underwent ceftriaxone sodium and metronidazole as empiric therapy for rhinosinusitis with initial subdural empyema. Four days after admission magnetic resonance imaging (MRI) revealed a subdural fluid collection in the temporal-parietal site on the left side. In the same surgical procedure craniotomy and left frontal sinus cranialization by an open access and maxillary sinuses toilette by functional endoscopic sinus surgery (FESS) were performed. The last clinical control done after 6 months showed completely regression of all symptoms. The occurrence of subdural empyema is an uncommon but possible sequel of sinusitis in adults. Prompt surgical management of subdural empyema and infected sinus is essential to obtain a rapidly regression of the symptoms and to avoid possible recurrence.

KEY WORDS: Infection - Complications - Sinusitis - Subdural empyema