INTRACRANIAL COMPLICATIONS OF SINUSITIS - THE NEED FOR AGGRESSIVE MANAGEMENT

Sinus-induced intracranial sepsis can represent a genuine medical and surgical emergency. We review 12 cases presenting to our hospitals ove r a five-year period. Nine were male and three were female with an age range of 16 to 74 years (mean 35.5 years). Four patients had their si nusitis diagnosed prior to admission and eight did not. Nine patients had bilateral sinus disease, the most common sinus involved a was the frontal followed by the ethmoid, maxillary and sphenoid. Neurosurgical drainage was via a craniotomy in seven cases and burr hole in three. Nine patients underwent sinus surgery and three did not. Of the nine w ho had sinus surgery three had frontal drainage, four fronto-ethmoidal and two transsphenoidal drainage. The most common organism was Strept ococcus milleri. Our series confirms that sinus-induced intracranial s epsis is a serious problem needing early diagnosis and aggressive trea tment. We would recommend a high index of suspicion of sinusitis in pa tients with intracranial infection.