DIABETES INSIPIDUS AND OTHER UNUSUAL COMPLICATIONS OF ACUTE PURULENT SINUSITIS

Abstract

The neurologic complications of infection of the paranasal sinuses are numerous and include pachymeningitis externa and extradural abscess, pachymeningitis interna and subdural abscess, circumscribed leptomeningitis, protective meningitis, bacterial meningitis, brain abscess, nonsuppurative encephalitis, thrombophlebitis of the intracranial venous channels and involvement of many cranial nerves. These complications present frequently perplexing diagnostic and therapeutic problems, defying the combined efforts of the otorhinologist, the ophthalmologist and the neurologist. The reasons for these difficulties have been discussed previously by one of us (Yaskin1). In the case to be discussed in this paper there occurred, in addition to the rather common basilar meningitis, the unusual complications of osteomyelitis of the lesser wing of the sphenoid bone, rapidly progressive optic neuritis, partial thrombotic occlusion of one of the middle cerebral arteries, changes in the hypothalamus and transient diabetes insipidus. In addition, the type of cortical destruction produced by occlusion of the middle cerebral artery