Clinical Outcomes of Sinogenic Intracranial Suppuration: The Alder Hey Experience

Abstract

The aim of this study was to present a series of cases of sinogenic intracranial suppuration in a pediatric tertiary referral center and to review the long-term outcomes of the patients. We performed a retrospective review of the hospital database and the patient case notes. Over 10 years, 14 patients were identified. The clinical presentations at the time of admission tended to include headache, vomiting, pyrexia, limb weakness, and decreased level of consciousness, in decreasing order of frequency. Sinonasal symptoms such as discharge and obstruction were only present in 36% and 21% of cases, respectively. The most common intracranial complication was subdural empyema in the frontal lobe region. The mortality rate was 21% (3 of 14). The remaining 11 patients remained alive at latest follow-up. The average follow-up period after hospital discharge was 19 months (median, 15 months; range, 6 to 64 months). No significant complications were noted in 4 patients, who had returned to normal daily activities at 6 months of follow-up. A significant proportion of patients who survived have some form of neurologic sequelae, although 64% of cases became asymptomatic in the 12 months following hospital discharge. The significant risk of morbidity and mortality of this disease requires a multidisciplinary approach that is best delivered at a tertiary referral center.