Vascular and Neurological Complications in Sphenoid Sinusitis.

Cureus

Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

Published: August 2024

AI Article Synopsis

  • Vascular complications from sphenoid sinusitis are uncommon because the mucosa and bone act as barriers, but certain conditions like dehiscence or aggressive infections can increase risks, potentially leading to severe issues like cavernous sinus thrombosis.
  • Untreated or severe cases of sphenoid sinusitis can result in serious neurological problems, including cerebral infarcts, meningitis, and cranial nerve injuries, which can be detected early with MRI and angiography.
  • A reported case of an 11-year-old boy illustrates these risks, as he experienced multiple complications from sphenoid sinusitis, including a cerebral artery infarct and various types of thrombosis due to associated mastoiditis.

Article Abstract

Although the cavernous sinus and internal carotid artery are in close proximity to the sphenoid sinus, vascular complications in sphenoid sinusitis are rare due to the intervening mucosa and bone. Variations like dehiscence or aggressive infection can cause vascular complications, leading to cavernous sinus thrombosis, while perivascular inflammation of the internal carotid artery can result in stenosis or occlusion. Untreated or aggressive sphenoid sinusitis can cause neurological complications such as cerebral infarcts, meningitis, subdural empyema, cerebral abscess, and cranial nerve injuries. Magnetic resonance imaging (MRI) of the brain with angiography can depict these complications at an early stage. Additionally, mastoiditis can cause dural venous sinus thrombosis, which, if left untreated, can result in venous infarcts. We report a case of an 11-year-old male with sphenoid sinusitis who developed a left middle cerebral artery (MCA) territory infarct, cavernous sinus thrombophlebitis, subdural empyema, and meningitis. He also developed left transverse and sigmoid sinus thrombosis due to left mastoiditis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373369PMC
http://dx.doi.org/10.7759/cureus.66181DOI Listing

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