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Neurological complications with acute sphenoid sinusitis a surgical emergency?

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Abstract

Background

Isolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe headache, with the potential of serious neurologic complications.

Objectives

To describe two patients with acute sphenoid sinusitis who presented with acute onset of severe headache and consider the role of surgical management.

Design

Case report

Setting

Tertiary care hospital

Results

Patient 1 developed right cavernous sinus thrombosis and permanent visual loss in one eye, requiring sphenoidotomy following failure of medical treatment. Patient 2 experienced failure of the medical treatment. However, sphenoidotomy abated all his symptoms without any neurologic sequelae.

Conclusion

It is important to be aware of acute sphenoid sinusitis in the setting of new onset severe headache, when imaging studies are unrevealing for intracranial pathology. Considering the serious consequences of failed medical treatment vis-à-vis the safety and efficacy of sphenoidotomy we propose surgical intervention at the time of diagnosis.

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Acknowledgment

The authors wish to thank Dr John Fisher for his helpful comments on the manuscript.

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Authors and Affiliations

  1. Department of Neurology, Hartford Hospital and University of Connecticut School of Medicine, 80 Seymour Street, Hartford, CT, 06102-5037, USA

    Markos Poulopoulos & Pasquale F. Finelli

Authors
  1. Markos Poulopoulos
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  2. Pasquale F. Finelli
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Corresponding author

Correspondence to Pasquale F. Finelli.

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Poulopoulos, M., Finelli, P.F. Neurological complications with acute sphenoid sinusitis a surgical emergency?. Neurocrit Care 7, 169–171 (2007). https://doi.org/10.1007/s12028-007-0036-6

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  • DOI: https://doi.org/10.1007/s12028-007-0036-6

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