Radiological Diagnosis of Intra-Cranial Complication of Sinusitis

Abstract

Background:Intracranial Complications of Paranasal sinusitis are comparatively rare in the
antibiotic era but may be fatal ; however, a significant proportion of patients (5–40%) can be
affected by intracranial Complications of sinusitis and the condition may be fatal in(50%), mostly
due to the delayed diagnosis of the disease.This study aimed to assess the role of radiological
diagnosis in assessment and timing of surgical intervention in sinusitis patients complicated with
intracranial complications.Patients and Methods:This study included twenty four patients with
chronic sinusitis with intracranial complications. The study was done in Otorhinolaryngology
Department in Zagazig University Hospitals from August 2021 to February 2022. Patient age
ranged from 19 to 70 years with a mean of 52.6 ± 10.68. They were 6 males and 18 females. All
the patients had radiological investigation CTPNs 'brain, MRI PNS ' Brain. Results:showed that
2 male patients had temporal lobe abscess with mean age of 66.3 years they presented with facial
pain and edema, fever, proptosis, nasal obstruction, nausea, vomiting and headache. 2 patients
had Subdural empyema, 1 of them is male and other female with mean 22.3 years, they presented
with fever, headache and vomiting and personality changes. 2 patients had cerebellar abscess one
of them are male with age 45 and other female with age 45 and 57 years respectivly they
presented with fever ,chills, vomiting , headache ,seizure,vertigo, nystagmus and imbalance. 2
male patients had extradural inflammatory abscess with frontal lobe with mean age of 21.3 years
they presented with low grade fever, vomiting ,headache and frontal manifestation. All patients
undergo surgical debridement of diseased tissues. Drilling and tabing of the abscess done by
neurosurgeon in neurosurgery department. One patient died (50%). Conclusions:Although CT is
excellent for imaging the bone, selective use of MRI and MRV based on history and exam
findings are recommended to definitively rule out intracranial extension.