Summers L E, Mascott C R, Tompkins J R, Richardson D E
Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Surg Neurol. 2001 Apr;55(4):235-9. doi: 10.1016/s0090-3019(01)00344-5.
Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. We present an unusual case of a frontal sinus osteoma leading to intracerebral abscess formation.
A 51-year-old Hispanic man presented with increasing frontal headaches, new onset seizure, lethargy, global dysphasia, and unilateral hemiparesis. CSF studies demonstrated mild pleocytosis. Neuroradiological studies revealed an opacity filling the left frontal sinus, as well as a ring-enhancing mass with surrounding edema in the left frontal lobe. The patient was surgically treated with a left frontal osteoplastic craniotomy and removal of the abscess and bony mass. Intraoperative cultures were positive for Streptococcus pneumoniae. Pathology revealed bony tumor consistent with osteoma. The patient's neurological status improved to baseline after surgery.
The frontal sinus osteoma was associated with rapid development of a frontal lobe abscess, requiring emergent surgical debridement. Although rare, intracerebral manifestations should be considered and expected as a cause of new neurological deficits in the presence of paranasal sinus osteoma.
鼻窦骨瘤很少导致颅内表现。我们报告一例罕见的额窦骨瘤导致脑内脓肿形成的病例。
一名51岁的西班牙裔男性出现进行性额部头痛、新发癫痫、嗜睡、完全性失语和单侧偏瘫。脑脊液检查显示轻度细胞增多。神经放射学检查发现左侧额窦有密度增高影，以及左侧额叶有环形强化肿块伴周围水肿。患者接受了左侧额部骨成形开颅手术，切除脓肿和骨质肿块。术中培养出肺炎链球菌。病理显示骨肿瘤符合骨瘤。术后患者的神经功能状态恢复至基线水平。
额窦骨瘤与额叶脓肿的快速发展有关，需要紧急手术清创。尽管罕见，但在鼻窦骨瘤存在的情况下，应考虑并预期颅内表现是新的神经功能缺损的原因。
