Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 50 Seongan-ro, 05355 Gangdong-gu, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 50 Seongan-ro, 05355 Gangdong-gu, Seoul, Korea.
Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Dec;135(6):457-459. doi: 10.1016/j.anorl.2018.03.006. Epub 2018 Oct 15.
Intracranial complications of acute rhinosinusitis are rare, but may turn life-threatening.
We report a healthy 30-year-old male who complained of frontal headache, which developed while on a plane. A brain CT showed a low-density lesion on the left frontal convexity with right maxillary and ethmoid sinusitis. Despite receiving intravenous antibiotics, a follow-up brain CT showed two lesions with adjacent dural and leptomeningeal enhancement. A paranasal sinus CT revealed aggravated left frontal sinusitis and right maxillary sinusitis. The patient underwent craniotomy and brain abscess removal along with endoscopic sinus surgery. Seventeen days after the surgery, the patient was discharged with no neurological sequelae.
To the best of our knowledge, this case is the first report regarding the association between barotrauma and intracranial complications of acute rhinosinusitis. A high index of suspicion and well-timed surgical evacuation may ensure a full recovery.
急性鼻-鼻窦炎的颅内并发症较为罕见，但可能危及生命。
我们报告了一例健康的 30 岁男性患者，其主诉为在飞机上出现的额部头痛。颅脑 CT 显示左侧额凸面有一低密度病灶，同时伴有右侧上颌窦和筛窦炎症。尽管给予了静脉抗生素治疗，但后续的颅脑 CT 显示有两个病灶伴有相邻硬脑膜和软脑膜增强。鼻窦 CT 显示左侧额窦炎和右侧上颌窦炎加重。患者接受了开颅术和脑脓肿切除，以及鼻内镜鼻窦手术。术后 17 天，患者出院，无神经后遗症。
据我们所知，本例是首例报道气压创伤与急性鼻-鼻窦炎的颅内并发症相关的病例。高度怀疑和及时的手术清除可能确保完全康复。
