0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Note |

Prepontine Epidural Abscess A Rare Complication of Bacterial Rhinosinusitis

Alejandro Vazquez, MD; Tekchand Ramchand, BA; Arjuna B. Kuperan, MD; James K. Liu, MD; Jean Anderson Eloy, MD
Arch Otolaryngol Head Neck Surg. 2012;138(5):512-514. doi:10.1001/archoto.2012.438.
Text Size: A A A
Published online

Extract

Prepontine epidural abscesses are extremely rare disease entities. To our knowledge, only 2 previous cases have been reported in the literature, neither of which was attributed to rhinosinusitis. Although the precise incidence of intracranial complications of rhinosinusitis is unknown, it is estimated that 3% to 4% of patients who are hospitalized for sinusitis develop central nervous system involvement. Suppurative intracranial complications of acute bacterial rhinosinusitis (ABRS) include subdural empyema, epidural and intraparenchymal abscesses, meningitis, thrombosis of the dural sinuses, and cavernous sinus thrombosis. We report an unusual case of a prepontine epidural abscess that developed from ethmoid and sphenoid bacterial sinusitis and resulted in right sixth nerve palsy. Institutional review board approval was obtained from the University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Preoperative computed tomographic (A) and magnetic resonance (B-D) images. A, A preoperative axial computed tomogram shows opacification of the sphenoid sinuses and the right ethmoid sinus, with a bony defect in the posterior wall of the right sphenoid sinus and a right paramedian clival collection (arrow). Preoperative T1-weighted gadolinium-enhanced sagittal (B) and axial (C) and T2-weighted (D) images of the brain reveal a right paramedian prepontine collection (arrows) immediately anterior to the basilar artery.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Preoperative (A and B), intraoperative (C), and postoperative (D) magnetic resonance images. Preoperative axial (A) diffusion-weighted image shows a hyperintense right paramedian prepontine collection (arrow) with corresponding hypointensity on apparent diffusion coefficient (B) imaging consistent with restricted diffusion suggestive of an abscess. C, An intraoperative image shows purulent discharge from the right clival defect (arrow). D, A T1-weighted gadolinium-enhanced sagittal image of the brain reveals complete resolution of the prepontine collection.

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

82 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();