Document Detail


Suppurative intracranial complications of sinusitis in adolescence. Single institute experience and review of literature.
MedLine Citation:
PMID:  18071989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to investigate the outcome of neurosurgical treated children with suppurative intracranial complications (SIC) of sinusitis over the past 28 years in our hospital. We reviewed the cases notes of a series of 11 consecutive paediatric patients, who were subjected to surgery for sinusitis-induced SIC, retrospectively. Eleven children (10 males and only one female) were underwent neurosurgical procedure in our hospital between 1978 and 2006. Their age at the time of diagnosis ranging from 13 to 17 years (mean 15.27 years, SD 1.737). The commonest presenting symptoms were headaches (81.8%) followed by vomiting (45.5%) and swelling of the forehead (45.5%). The most often involved sinus was the frontal sinus (63.6%) and sinus surgery was performed in eight (72.72%) of 11 cases. The neurosurgical procedures carried out included burr hole drainage or aspiration of abscess in five cases, craniotomy and evacuation of empyema in seven cases and craniectomy in two cases. Four (36.4%) of 11 patients had more than one neurosurgical operation due to re-accumulation of pus and worsening of their clinical status. Most common pathogen was Streptococcus species (81.9%), and anaerobes were isolated in three (27.3%) cases. Postoperative antibiotic treatment lasted from 26 to 70 days (mean 45.45 days, SD 15.280). Epilepsy was diagnosed in two patients, postoperatively. During the follow-up period, persistent focal neurological deficits were present in five (45.5%) of 11 patients. Interestingly, five (45.45%) cases occurred over the last 2 years (2005-2006) and the other six over the previous 16 years (1978-2006). Prompt and aggressive medical and neurosurgical intervention is required, aiming to minimize the morbidity and mortality and also to maximize the favourable outcome of those children.
Authors:
D Kombogiorgas; R Seth; R Athwal; J Modha; J Singh
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  British journal of neurosurgery     Volume:  21     ISSN:  0268-8697     ISO Abbreviation:  Br J Neurosurg     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-11     Completed Date:  2008-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8800054     Medline TA:  Br J Neurosurg     Country:  England    
Other Details:
Languages:  eng     Pagination:  603-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University Hospital of North Staffordshire, Stoke-on-Trent, UK. dkomb@onetel.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anti-Bacterial Agents / therapeutic use
Bacterial Infections* / drug therapy,  microbiology,  surgery
Empyema, Subdural* / drug therapy,  microbiology,  surgery
Epidural Abscess* / drug therapy,  microbiology,  surgery
Female
Follow-Up Studies
Humans
Male
Neurosurgical Procedures / methods
Retrospective Studies
Sinusitis* / drug therapy,  microbiology,  surgery
Suppuration / drug therapy,  microbiology,  surgery
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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