Three adeolescent cases of rhinogenic intracranial complications are reported.
Case#1 was an 11-year-old girl diagnosed with a rhinogenic subdural and extradural abscess. Case#2 was a 15-year-old girl diagnosed with a rhinogenic subdural abscess and bacterial meningitis. Case#3 was a 13-year-old boy diagnosed with a rhinogenic subdural abscess and bacterial meningitis. All three cases were successfully treated using broad-spectrum antibiotics, sinus surgery and neurosurgical drainage. Streptococcus intermedius was identified in all three cases.
The development of antibiotic therapy and sinus surgery is thought to have reduced postoperative intracranial complications. Recent reports suppose that idiopathic frontal sinusitis is the most frequent cause of intracranial complications.
The development of antibiotic therapy would have been reducing intracranial complications. Relatively speaking, the idiopathic cases are increasing, and the postoperative cases are decreasing due to the development of sinus surgery. Idiopathic frontal sinusitis was the cause of the intracranial complications in all of the presently reported cases. The paranasal sinuses were fully developed in all three patients, and they experienced fewer nasal symptoms than usual.
Subdural abscesses are rare, and sinusitis is thought to be the major cause of this disease. Therefore, a complete examination should be performed in cases with frontal sinusitis and neurological symptoms, such as headache or fever, to rule out the possibility of intracranial complications. Magnetic resonance imaging is more useful than computed tomography for the early detection of intracranial lesions.
