The diagnostic significance of posttraumatic sphenoid sinus effusions: correlation with head computed tomography.

In review of 1544 patients with both head computed tomography (CT) examinations and skull radiographs, 150 patients were found to have a history of acute head trauma. Twenty-nine of these patients had sphenoid sinus effusions. Ninety-three percent (27/29) of those cases had abnormal CT examinations, as compared with 48% (58/121) of cases without sphenoid effusions. Of the patients with sphenoid effusions, 31% (9/29) had intracerebral hematomas, 24% (7/29) had extracerebral hematomas, 13% (4/29) had pneumocephalus, and 13% (4/29) had cerebral edema. We conclude that the presence of posttraumatic sphenoid sinus effusion on the skull radiograph is a sensitive sign for intracranial damage and serves as an emergent indication for head CT.