A case of subdural empyema
secondary
to odontogenic maxillary sinusitis
Satoru SAITOH, Ikuo KASAI, Makoto OHNISHI*
Department of Dentistry, Tachikawa General Hospital,
Tachikawa Medical Center (Chief: Dr. Ikuo KASAI)
*Department of Dentistry and Oral Surgery,
Nagaoka Red Cross Hospital (Chief: Dr. Makoto OHNISHI )
Abstract: Recently, intracranial complications secondary to dental
infections and dental treatments have decreased because that
antibiotics and diagnostic imagings are developed. Some recent
reports however show that intracranial complications of paranasal
sinus infections increase in number, indicating that we should be
aware of the potential for these complications. In addition, it is
difficult to ascertain routes of intracranial extension; either
anatomic or hematogenous routes. We reported a case of subdural
empyema caused by odontogenic maxillary sinusitis through
hematogenous routes. A 25-year-old male was admitted to the hospital
because of a frontal headache, his left eyelid swelling and a fever.
He was diagnosed as acute pan-sinusitis caused by odontogenic
maxillary sinusitis. Despite antibiotics administration, his
consciousness became drowsy, and thrombophlebitis was found in aural
veins. It is considered that inflammation spread from paranasal sinus
to intracranium through blood-streams. Broadspectrum antibiotics were
administered, but his symptoms were not reduced. Though a radical
sinusotomy was performed, his consciousness was still drowsy, and the
subdural empyema was revealed by MRI. Since the subdural empyema was
diminished by the craniotomy, maxillary teeth as an infectious origin
were extracted. Afterward, he was discharged without any sequelae.
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