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    Go to the top of the page   ID: 20021227193320 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Roland Talanow, Wolfgang Hirsch (Cleveland/USA; Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    10 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    inflammatory or infectious  

     
     Pediatric Radiology CasesHistory:

    10 year-old boy with changes in behaviour for 8 days noticed by parents. Since the day before hospital admission, the boy had a fever of 39,5°C. Admission to the hospital and CT performed with the concern for brain hemorrhage.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Congenital defects of the frontal sinus after sinusitis can lead to permeative inflammations of the meninges. An abscess development is possible.  

     
     Pediatric Radiology CasesRadiological findings:


    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Laboratory diagnostics  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Multiple confluent brain metastases  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Several surgeries in the region of the right frontal sinus. A drainage of the abscesses were not done (reason?).

    The subsequent therapy with antibiotics and hyperbaric oxygenation lead, however, to a continuous regression of the abcesses.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Brain abscess, frontal sinus, abscess, congenital defect, sinus frontalis, frontal sinus, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: inflammatory or infectious
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

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    Congenital frontal sinus defect complicated by multiple brain abscesses
    Other cases by these authors:

    Search Roland Talanow in Medline Roland Talanow (9)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   

    Congenital frontal sinus defect complicated by multiple brain abscesses  
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

    Which diagnosis have other collegues guessed?


    • Brain abscess
      Votes: 14 (82 %)


    • Confluent Metastases
      Votes: 3 (17 %)


    • Astrocytoma
      Votes: 0 (0 %)


    • Glioblastoma multiforme
      Votes: 0 (0 %)



        Total answers: 17

     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

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    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     




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