Life-threatening intracranial complication of inflammation of the sphenoid sinuses: Clinical observation

Introduction:

Through the clinical observation, we would like to emphasize that in some cases, acute sphenoiditis can develop without typical symptoms and can be diagnostic only if intracranial spread of bacterial infection.

Presentation of case:

From anamnesis: we asked a 62 year old patient with complaints expressed headaches, blindness to the right and a significant impairment on the left, dizziness, disorientation and fever. It is known that for 1 month prior to treatment the patient had got a cold, after which he recovered completely. Three weeks later, she developed the above symptoms.

Diagnostics:

In the study of cerebrospinal fluid confirmed the presence of a purulent meningitis with a typical increase of cellular elements. When a CT scan discovered a total shading of the sphenoid sinus, multiple defects of the bony walls and destruction the septum between the sinuses. According to MRT could not exclude the presence of tumor of the sphenoid sinus.

Treatment:

The patient urgently was performed endoscopic sphenoidotomy. Immediately after perforation of the anterior wall of the sphenoid sinus appeared pus under pressure. Post-operative treatment in addition to antibiotic therapy included daily endoscopic debridement of the sphenoid sinus. After the surgery recovery is gone well. The tumor histologically was excluded. When examination after 24 months, unfortunately, remains blindness to the right, but vision on the left is greatly improved.

Conclusion:

The leading role in the successful treatment in the presented case belongs in a timely manner endoscopic intervention and comprehensive multidisciplinary postoperative treatment.

Publication History

Publication Date:
18 April 2018 (online)