INFECTIOUS INTRACRANIAL COMPLICATIONS OF SINUSITIS, OTHER THAN MENINGITIS, IN CHILDREN - 12-YEAR REVIEW

Sinusitis is usually a mild illness in children, but intracranial comp lications can be life-threatening. We retrospectively reviewed nine ca ses of intracranial infections secondary to paranasal sinusitis that o ccurred over a 12-year period, excluding patients with orbital infecti on only. Cases were highly age- and sex-associated: the median age was 14 years, 89% of patients were >9 years of age, and seven (78%) of th e nine patients were male. Symptoms included fever (67%), headache (67 %), eye swelling (56%), and seizure (33%). Rhinorrhea was uncommon (22 %). Only two patients (22%) had had previous episodes of sinusitis. St aphylococcus aureus and anaerobes were the predominant intracranial is olates. Computed tomography scans of the head showed progression of di sease in patients treated with antibiotics alone; surgical drainage wa s required for all patients. The duration of therapy after surgery was 3-8 weeks. Only one patient (11%) had persistent neurological sequela e. We conclude that (1) teenage males are at greatest risk of developi ng intracranial infections from sinusitis, (2) common symptoms of sinu sitis such as rhinorrhea may not always occur, and (3) outcome can be excellent when a combined medical! surgical approach is used for thera py.