RT Book, Section A1 Holmes, Janalee A1 Malhotra, Prashant A2 Usatine, Richard P. A2 Sabella, Camille A2 Smith, Mindy Ann A2 Mayeaux, E.J. A2 Chumley, Heidi S. A2 Appachi, Elumalai SR Print(0) ID 1114870167 T1 Complications of Sinusitis T2 The Color Atlas of Pediatrics YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-176701-9 LK accesspediatrics.mhmedical.com/content.aspx?aid=1114870167 RD 2024/04/19 AB A 10-year-old girl has a 2-week history of daily headaches and rhinorrhea. She is admitted from the emergency department to the pediatric intensive care unit for a 2-day history of worsening left frontal headache, mental status changes including lethargy and slurred speech, nausea, and mild periorbital edema. Computed tomography (CT) demonstrates opacification of bilateral frontal, maxillary, and anterior ethmoid sinuses as well as pneumocephalus (Figure 27-1A). Magnetic resonance imaging demonstrated extensive left sided subdural empyema (worse frontal and temporal) and diffuse bilateral dural enhancement (Figure 27-1B). She is urgently treated via a combined surgical approach with pediatric otolaryngology for bilateral endoscopic sinus surgery and pediatric neurosurgery for left craniotomy. She subsequently had 10 weeks of intravenous antimicrobial therapy. Her immediate postoperative course was complicated by seizures; she has now made a full recovery and is doing well.