Righini Christian Adrien, Bing Fabrice, Bessou Pierre, Boubagra Kamel, Reyt Emile
Department of Otorhinolaryngology-Head and Neck Surgery, Albert Michallon University Hospital, Grenoble, Cedex 09, France.
Ear Nose Throat J. 2009 Nov;88(11):E23-8.
Acute isolated sphenoid sinusitis is a relatively uncommon entity. Because its symptoms and clinical findings are nonspecific, it can be easily misdiagnosed. Left unrecognized and untreated, it can lead to several well-known and severe complications, including meningitis, cerebral abscess, cavernous sinus thrombosis, and epidural or subdural empyema. We report the case of a 28-year-old woman with acute sphenoid sinusitis complicated by ischemic stroke in the left caudate nucleus, lentiform nucleus, and posterior part of the internal capsule. The stroke was diagnosed on magnetic resonance imaging. Also, magnetic resonance angiography showed a narrowing of the internal carotid artery and a narrowing of the first part of the left anterior and middle cerebral arteries (A1 and M1 segments). The patient was treated with medical therapy, including antibiotics, and surgical drainage of the sphenoid sinus via an endoscopic approach. Her outcome was good, and she experienced minimal neurologic sequelae. We discuss the possible explanations for this rare complication.
急性孤立性蝶窦炎是一种相对罕见的疾病。由于其症状和临床发现不具特异性，很容易被误诊。若未被识别和治疗，它可导致多种众所周知的严重并发症，包括脑膜炎、脑脓肿、海绵窦血栓形成以及硬膜外或硬膜下积脓。我们报告一例28岁女性，患有急性蝶窦炎并并发左侧尾状核、豆状核及内囊后部缺血性卒中。该卒中通过磁共振成像得以诊断。此外，磁共振血管造影显示颈内动脉狭窄以及左侧大脑前动脉和大脑中动脉第一部分（A1和M1段）狭窄。患者接受了包括抗生素在内的药物治疗，并通过内镜方法对蝶窦进行了手术引流。她的预后良好，神经后遗症极少。我们讨论了这种罕见并发症的可能原因。
