Abstract
IntroductionTo date intracranial complication caused by tooth extractions are extremely rare. In particular parietal subdural empyema of odontogenic origin has not been described. A literature review is presented here to emphasize the extreme rarity of this clinical entity.Case presentationAn 18-year-old Caucasian man with a history of dental extraction developed dysarthria, lethargy, purulent rhinorrhea, and fever. A computed tomography scan demonstrated extensive sinusitis involving maxillary sinus, anterior ethmoid and frontal sinus on the left side and a subdural fluid collection in the temporal-parietal site on the same side. He underwent vancomycin, metronidazole and meropenem therapy, and subsequently left maxillary antrostomy, and frontal and maxillary sinuses toilette by an open approach. The last clinical control done after 3 months showed a regression of all symptoms.ConclusionsThe occurrence of subdural empyema is an uncommon but possible sequela of a complicated tooth extraction. A multidisciplinary approach involving otolaryngologist, neurosurgeons, clinical microbiologist, and neuroradiologist is essential. Antibiotic therapy with surgical approach is the gold standard treatment.
Highlights
To date intracranial complication caused by tooth extractions are extremely rare
The literature on intracranial complications of sinusitis consists mainly of case reports with the exception of a few large series of hospitalized patients that present a rate of intracranial complications that varies from 3.7% to 47.6% [2,6,7]
We report a rare and insidious case of parietal subdural empyema evolving over 2 weeks, secondary to dental extraction
Summary
To date intracranial complication caused by tooth extractions are extremely rare. In particular parietal subdural empyema of odontogenic origin has not been described. A computed tomography scan demonstrated extensive sinusitis involving maxillary sinus, anterior ethmoid and frontal sinus on the left side and a subdural fluid collection in the temporal-parietal site on the same side. He underwent vancomycin, metronidazole and meropenem therapy, and subsequently left maxillary antrostomy, and frontal and maxillary sinuses toilette by an open approach. The literature on intracranial complications of sinusitis consists mainly of case reports with the exception of a few large series of hospitalized patients that present a rate of intracranial complications that varies from 3.7% to 47.6% [2,6,7].
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