Intracranial complication of acute paranasal sinusitis during active COVID-19 infection – a case report

Abstract

According to various sources, complications of sinusitis occur with a frequency of between 3 and 17%. Intracranial complications include: meningitis, epidural abscess, subdural abscess, brain abscess, and thrombophlebitis of the dura mater and the brain. The most common intracranial complications are inflammations of the frontal, ethmoid and sphenoid sinuses. A brain abscess is the second most common intracranial complication in the course of sinusitis after meningitis. The presented case concerns a 16-year-old patient treated for brain abscesses and CNS sinus thrombosis in the course of acute purulent inflammation of the frontal and maxillary sinus on the right side. The management of intracranial complications of acute paranasal sinusitis according to EPOS 2022 is high doses of intravenous antibiotics used for a long period, neurosurgical surgical treatment consisting in drainage of abscesses through craniotomy, drainage of the frontal sinus from external or endoscopic access. The prognosis of intracranial complications most often depends on the severity of neurological symptoms and appropriate prompt treatment implementation.