Intracranial empyema complicating sinusitis in childhood: Epidemiology, imaging findings and outcome - Centre de Résonance Magnétique des Systèmes Biologiques Accéder directement au contenu
Article Dans Une Revue International Journal of Pediatric Otorhinolaryngology Année : 2022

Intracranial empyema complicating sinusitis in childhood: Epidemiology, imaging findings and outcome

Sara Agouzoul
  • Fonction : Auteur
Thomas Sagardoy
  • Fonction : Auteur
Jean Delmas
  • Fonction : Auteur
Pierre Bessou
  • Fonction : Auteur
Marion Havez
  • Fonction : Auteur
Morgan Ollivier
  • Fonction : Auteur

Résumé

BACKGROUND: To describe clinical presentations of intracranial sinusitis complications in childhood, their pitfalls and imaging findings. MATERIEL AND METHODS: This retrospective IRB-approved single-center study included infants diagnosed with sinusitis and empyema and/or other intracranial complications who underwent imaging between September 2008 and September 2019. Three radiologists individually reviewed clinical charts and imaging findings, including sinusitis complications and at-risk anatomical variations. RESULTS: 21 children (76% males and 24% females, mean age 13±3.1 years) with imaging pansinusitis were included. Headache (95%) and fever (90%) were the main clinical nonspecific signs. Ten (48%) children presented an extradural empyema, nine (43%) children had a subdural empyema and two (10%) children had both. Frontal location sinusitis was the most common (76%). In MRI, all empyema presented as a hypo intensity on pre-contrast T1-WI, a hyperintensity on T2-WI, a reduced apparent diffusion coefficient (ADC) on diffusion weighted imaging (DWI) and a peripheral contrast enhancement on post-contrast T1-WI. CT or MRI revealed intracranial complications such as a collection size increase (52%), a midline shift (62%), intraparenchymal abscesses (24%), a cerebral venous thrombosis (29%), an intracranial pressure increase (29%), cerebral ischemia (43%) and Pott's Puffy Tumor (10%). Imaging highlighted sinus anatomical abnormalities in 52% of cases. All children were treated with sinus drainage and/or neurosurgery. Long-term follow-up was favorable in 14 cases (67%). CONCLUSION: Complications of sinusitis are life threatening in the studied population. Empyema and cerebral complications may be misleading. Brain contrast-enhanced CT covering sinuses and orbits, is mainly the first examination done but MRI is mandatory.
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Dates et versions

hal-03834851 , version 1 (31-10-2022)

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Sara Agouzoul, Julien Coelho, Thomas Sagardoy, Jean Delmas, Pierre Bessou, et al.. Intracranial empyema complicating sinusitis in childhood: Epidemiology, imaging findings and outcome. International Journal of Pediatric Otorhinolaryngology, 2022, 162, ⟨10.1016/j.ijporl.2022.111299⟩. ⟨hal-03834851⟩

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