International Journal of Pediatric Otorhinolaryngology 78 (2014) 385–387
Contents lists available at ScienceDirect
International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl
Case report
Epidural hematoma secondary to sinusitis: A case report and review of the literature Shraga Aviner a,b,*, Noam Olshinka c, Evgenia Cherniavsky b,d, Boaz Forer b,e, Haim Bibi a,b a
Department of Pediatrics, The Barzilai Medical Center Ashkelon, Israel Faculty of Health Sciences, The Barzilai Medical Center Campus, Ben-Gurion University of the Negev, Ashkelon, Israel c Orthopedic department, Hebrew University Hadassah Medical Center, Jerusalem, Israel d Department of Medical Imaging, The Barzilai Medical Center Ashkelon, Israel e Department of Ear Nose and Throat, The Barzilai Medical Center Ashkelon, Israel b
A R T I C L E I N F O
A B S T R A C T
Article history: Received 15 October 2013 Received in revised form 27 November 2013 Accepted 28 November 2013 Available online 6 December 2013
Epidural hematoma is a potentially life threatening event that demands prompt diagnosis and surgical treatment, usually following head trauma. We present a case of a 9-year-old boy with no history of head trauma, and who was diagnosed with epidural hematoma secondary to frontal sinusitis; and the medical literature was reviewed. ß 2013 Elsevier Ireland Ltd. All rights reserved.
Keywords: Epidural hematoma Sinusitis
1. Introduction Epidural hematoma requires prompt recognition and surgical intervention in order to prevent neurologic sequelae and death. The most frequent mechanism of injury is head trauma, although rarely epidural hematoma (EH) can result from adjacent infection, coagulation disorder, vascular malformation, or tumor. We report a case of a 9-year-old boy with past medical history of mild cerebral palsy (CP) who presented with EH due to frontal sinusitis. Review of the English literature revealed only 11 cases of EH secondary to sinusitis. 2. Case report A nine-year-old boy was brought to the emergency room with complains of left frontal headache, vomiting, cough, and abdominal pain for two days, and fever of 40 8C for one day. He didn’t notice photophobia or aura. His bowel movement and urine output were normal. There were no purulent rhinorrhea, nasal obstruction, or anosmia, and acute sinusitis was ruled out clinically by an outpatient ear nose and throat specialist
* Corresponding author at: Department of Pediatrics, Barzilai Medical Center 2 Hahistadrut St., Ashkelon 78278, Israel. Tel.: +972 8 674 5165; fax: +972 8 674 5468. E-mail address: [email protected] (S. Aviner). 0165-5876/$ – see front matter ß 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijporl.2013.11.035
His past medical history is remarkable for minor cerebral palsy with mild left hypotonia treated with physiotherapy and hydrotherapy. On physical examination he appeared fully conscious and cooperative. Heart rate was 150 beats per minute. Diffuse abdominal tenderness with guarding without rebound was noted. Neurologic examination revealed a mild left central facial nerve paralysis with no signs of meningeal irritation. No signs of head trauma were noted. Laboratory studies showed a white blood count of 16,360 17.3 109/L, blood sodium 131.3 mg/dL (normal 135–145 mg/dL) and CRP of 197 mg/dL (normal < 5 mg/dL). Other CBC components, electrolytes, renal, and liver functions and coagulation studies were within normal limits. An emergency non-contrasted computerized tomography (NCCT) revealed a large epidural hyper-dense collection, consistent with epidural hematoma with gas bubbles. No fracture lines or other signs of trauma were noted. The scan also demonstrated bilateral ethmoid, frontal, and maxillary sinus opacification without frontal bone involvement (Fig. 1). Craniotomy was performed and a 3 2 cm hematoma was removed. Culture of the evacuated fluid revealed a non typeable Haemophilus influenzae, and IV ceftriaxone and metronidazole was administered. 3. Discussion We describe a case of a 9-year-old child with EH secondary to acute sinusitis, who presented with symptoms of head ache,
S. Aviner et al. / International Journal of Pediatric Otorhinolaryngology 78 (2014) 385–387
386
Fig. 1. (A). A non-contrasted computerized tomography (NCCT) of the brain demonstrated a large epidural hyper-dense collection, most likely a hematoma with entrapped gas bubbles. (B, C). Sagittal and coronal reconstructions of the NCCT of the brain demonstrated signs of bilateral frontal sinusitis (arrow). Notable is the normal subcutaneous fat in the frontal area (arrowhead). Bone destruction or fractures were not found.
abdominal pain, fever, and vomiting. We reviewed the medical literature and have been able to retrieve only 12 more cases of EH ascribed to sinusitis (Table 1). Indeed, two tertiary hospitals did not have any EH among 34 cases of intracranial complication of sinusitis over a ten-year period. [1,2] The rarity of this complication despite the high incidence of sinusitis suggests that some unrecognized factors are involved in its pathogenesis. The importance of rapid diagnosis and treatment of EH could not be overemphasized. Timely diagnosed and surgically treated patients are likely to fully recover, while a delay in diagnosis could result in permanent neurologic impairment, [3] and even death. [4] However, EH often begins as an insidious process, with a few neurologic signs and symptoms leading to delay in diagnosis. Patients might be asymptomatic as the infection is being contained by the dura, [3,5,6] and signs and symptoms are related to the sinusitis. Headache is the most common presenting symptom (12 out of 13 patients) followed by fever (8 patients, Table 1) and these might be the only symptoms. Neurologic symptoms including a decreased consciousness, [4,7–11] nausea and vomiting, [3,6,7,12,13] cranial nerve dysfunction [3,10,13] hemiparesis, [10,11] and seizures, [4] indicated intracranial complication, while symptoms that are related to the primary focus of infection mainly sinus ache may mask the correct diagnosis. These include orbital and periorbital swelling, [5,8,11,12,14] periorbital edema, [5,7] eyelid swelling, [4] strabismus, [7,8] exopthalmus, [5,11] tearing [3], and pain behind the eye. [4] Some patients present with purulent nasal discharge [9,14] and post nasal drip. [12]
EH appears more frequently in older children and young adults; 10 of the 13 patients in this cohort were 9–18 years on presentation. Our case, a 9-year-old boy, is the youngest described. This age distribution may reflect the fact that complications of sinusitis tend to occur more frequently in children than adults. In addition, the lack of EH due to sinusitis before the age of 9 years could be explained by the absence of the frontal sinus in children younger than 7 years, which makes frontal sinusitis a likely cause for EH. In rare cases the sphenoidal or maxillary sinuses may be involved, possibly via the retromaxillary plexus. Indeed, this pattern of sinus involvement is reflected in the preset cohort; 5 patients had pansinusitis, 4- frontal, 3- sphenoidal, and one had maxillary sinusitis (Table 1). EH is frequently infected as were 8 of the 13 hematoma that were reportedly cultured. Polymorphonuclear infiltrates in the leptomeninges suggests that the blood clot was contaminated from the beginning as demonstrated in some cases. [4,12] Alternatively, the hematoma itself is a good medium for bacterial growth and might be secondarily infected. EH complicating sinusitis does not appear to be bacterial specific, with five different organisms cultured from the hematoma. These include Hemophilus influenza [14] Staph aureus [4] Pseudomonas cepacia, [5] Streptococcus milleri [9], and Streptococcus anginosus, [12] each reported in one case. In two cases no organism was found. [6,13] Since these bacteria are usually found in the frontal sinus a drainage of this sinus might be indicated in selected cases.
Table 1 Summary of cases with SEH associated with sinusitis. Author (year)
Age (years)
Sex
Involved sinus
Hematoma location
Organism coltured
Outcome
Comments
Kelly (1968) [14] Ataya (1968) [8] Rajput (1971) [4] Marks (1982) [7] Sakamato (1997) [5] Papadopoulos (2001) [6] Moonis (2002) [3]
11 31 18 31 16 17 21
M M M M F M M
Pan-sinusitis Pan-sinusitis Frontal Pan-sinusitis Maxillary Frontal Sphenoidal
Frontal Frontal Frontal Frontal Frontal Frontal Temporal
Hemophilus influenzae ND Staph aureus ND Pseudomonas cepacia Non coltured ND
Orbital cellulitis
Griffiths (2002) [9]
17
F
Pan-sinusitis
Frontal
Streptococcus milleri
Full recovery Full recovery Died Full recovery Full recovery Full recovery Mild neurologic sequelae Full recovery
Chaiyasate (2007) [12] Takahashi (2010) [10]
14 10
F F
Pan-sinusitis Sphenoidal
Frontal Temporal
Streptococcus anginosus ND
Full recovery Full recovery
Cho (2011) [13] Spennato (2012) [11] Current case
17 12 9
F F M
Sphenoidal Frontal Frontal
Temporal Frontal Frontal
Non coltured ND Hemophilus influenzae
Full recovery Full recovery Full recovery
Congenital high palate & submucous cleft palate Bone defect between temporal base and sphenoid sinus
S. Aviner et al. / International Journal of Pediatric Otorhinolaryngology 78 (2014) 385–387
A contrast enhanced computerized tomography scan is the prefered imaging modality for a rapid diagnosis. A bone window should be carefully reviewed for sinus opacification, bony destruction, or osteomyelitis. MRI may add fine delineation of the structures. Since the signs and symptoms of EH are mild and non specific, detailed history of acute sinusitis (nasal obstruction, facial pain, and headache, purulent nasal discharge and anosmia) and endoscopic evaluation of the nose are important in order to establish the diagnosis of sinus infection. Attention to mild neurologic alterations and prompt imaging studies may lead to early diagnosis and treatment. Two possible mechanisms were proposed to explain the development of EH from a neighboring infection. The first one involves retrograde infection through valveless vessels leading to arteritis, weakening of the vessel wall and rupture. [11] The second assumes that the accumulation of bacterial products as pus, exudate, or air in the extradural space that causes a detachment of dura mater and bleeding. The true mechanism may involve a combination of the two mechanisms. [14] EH may cause a rapid and life threatening neurologic deterioration. A worsening headache or a new neurologic symptom, especially in a patient with a known sinusitis, should encourage the physician to get a CT scan. A rapid diagnosis of EH and prompt surgical intervention are the key factors for a favorable prognosis. 4. Conclusions EH due to sinusitis is a rare but potentially life threatening phenomenon. Presenting symptoms are sometimes minimal or absent and do not differ from those of sinusitis. Any suspected
387
symptom should encourage prompt evaluation by CT scan and immediate treatment to provide the best possible outcome. References [1] J.S. Glickstein, R.K. Chandra, J.W. Thompson, Intracranial complications of pediatric sinusitis, Otolaryngol. Head Neck Surg. 134 (2006) 733–736. [2] C.W. Hicks, J.G. Weber, J.R. Reid, M. Moodley, Identifying and managing intracranial complications of sinusitis in children: a retrospective series, Pediatr. Infect. Dis. J. 30 (2011) 222–226. [3] G. Moonis, A. Granados, S.L. Simon, Epidural hematoma as a complication of sphenoid sinusitis and epidural abscess: a case report and literature review, Clin. Imaging. 26 (2002) 382–385. [4] A.J. Rajput, B. Rozdilsky, Extradural hematoma following frontal sinusitis. Report of a case and review of the literature, Arch. Otolaryngol. 94 (1971) 83–86. [5] T. Sakamoto, K. Harimoto, S. Inoue, A. Konishi, Extradural hematoma following maxillary sinusitis. Case illustration, J. Neurosurg. 87 (1997) 87–132. [6] M.C. Papadopoulos, A. Dyer, C. Hardwidge, Spontaneous extradural haematoma with sinusitis, J. R. Soc. Med. 94 (2001) 588–589. [7] S.M. Marks, M.D. Shaw, Spontaneous intracranial extradural hematoma. Case report, J. Neurosurg. 57 (1982) 708–709. [8] N.L. Ataya, Extradural haematoma secondary to chronic sinusitis: a case report, J. Laryngol. Otol. 100 (1986) 951–953. [9] S.J. Griffiths, N.S. Jatavallabhula, R.D. Mitchell, Spontaneous extradural haematoma associated with craniofacial infections: case report and review of the literature, Br. J. Neurosurg. 16 (2002) 188–191. [10] Y. Takahashi, N. Hashimoto, A. Hino, Spontaneous epidural hematoma secondary to sphenoid sinusitis -case report-, Neurol. Med. Chir. (Tokyo) 50 (2010) 399–401. [11] P. Spennato, D. De Paulis, A. Bocchetti, A. Michele Pipola, G. Sica, R.J. Galzio, Spontaneous intracranial extradural haematoma associated with frontal sinusitis and orbital involvement, Neurol. Sci. 33 (2012) 435–439. [12] S. Chaiyasate, S. Halewyck, K. Van Rompaey, P. Clement, Spontaneous extradural hematoma as a presentation of sinusitis: case report and literature review, Int. J. Pediatr. Otorhinolaryngol. 71 (2007) 827–830. [13] K.S. Cho, W.H. Cho, H.J. Kim, H.J. Roh, Epidural hematoma accompanied by oculomotor nerve palsy due to sphenoid sinusitis, Am. J. Otolaryngol. 32 (2011) 355–357. [14] D.L. Kelly Jr., J.M. Smith, Epidural hematoma secondary to frontal sinusitis. Case report, J. Neurosurg. 28 (1968) 67–69.
Contents lists available at ScienceDirect
International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl
Case report
Epidural hematoma secondary to sinusitis: A case report and review of the literature Shraga Aviner a,b,*, Noam Olshinka c, Evgenia Cherniavsky b,d, Boaz Forer b,e, Haim Bibi a,b a
Department of Pediatrics, The Barzilai Medical Center Ashkelon, Israel Faculty of Health Sciences, The Barzilai Medical Center Campus, Ben-Gurion University of the Negev, Ashkelon, Israel c Orthopedic department, Hebrew University Hadassah Medical Center, Jerusalem, Israel d Department of Medical Imaging, The Barzilai Medical Center Ashkelon, Israel e Department of Ear Nose and Throat, The Barzilai Medical Center Ashkelon, Israel b
A R T I C L E I N F O
A B S T R A C T
Article history: Received 15 October 2013 Received in revised form 27 November 2013 Accepted 28 November 2013 Available online 6 December 2013
Epidural hematoma is a potentially life threatening event that demands prompt diagnosis and surgical treatment, usually following head trauma. We present a case of a 9-year-old boy with no history of head trauma, and who was diagnosed with epidural hematoma secondary to frontal sinusitis; and the medical literature was reviewed. ß 2013 Elsevier Ireland Ltd. All rights reserved.
Keywords: Epidural hematoma Sinusitis
1. Introduction Epidural hematoma requires prompt recognition and surgical intervention in order to prevent neurologic sequelae and death. The most frequent mechanism of injury is head trauma, although rarely epidural hematoma (EH) can result from adjacent infection, coagulation disorder, vascular malformation, or tumor. We report a case of a 9-year-old boy with past medical history of mild cerebral palsy (CP) who presented with EH due to frontal sinusitis. Review of the English literature revealed only 11 cases of EH secondary to sinusitis. 2. Case report A nine-year-old boy was brought to the emergency room with complains of left frontal headache, vomiting, cough, and abdominal pain for two days, and fever of 40 8C for one day. He didn’t notice photophobia or aura. His bowel movement and urine output were normal. There were no purulent rhinorrhea, nasal obstruction, or anosmia, and acute sinusitis was ruled out clinically by an outpatient ear nose and throat specialist
* Corresponding author at: Department of Pediatrics, Barzilai Medical Center 2 Hahistadrut St., Ashkelon 78278, Israel. Tel.: +972 8 674 5165; fax: +972 8 674 5468. E-mail address: [email protected] (S. Aviner). 0165-5876/$ – see front matter ß 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijporl.2013.11.035
His past medical history is remarkable for minor cerebral palsy with mild left hypotonia treated with physiotherapy and hydrotherapy. On physical examination he appeared fully conscious and cooperative. Heart rate was 150 beats per minute. Diffuse abdominal tenderness with guarding without rebound was noted. Neurologic examination revealed a mild left central facial nerve paralysis with no signs of meningeal irritation. No signs of head trauma were noted. Laboratory studies showed a white blood count of 16,360 17.3 109/L, blood sodium 131.3 mg/dL (normal 135–145 mg/dL) and CRP of 197 mg/dL (normal < 5 mg/dL). Other CBC components, electrolytes, renal, and liver functions and coagulation studies were within normal limits. An emergency non-contrasted computerized tomography (NCCT) revealed a large epidural hyper-dense collection, consistent with epidural hematoma with gas bubbles. No fracture lines or other signs of trauma were noted. The scan also demonstrated bilateral ethmoid, frontal, and maxillary sinus opacification without frontal bone involvement (Fig. 1). Craniotomy was performed and a 3 2 cm hematoma was removed. Culture of the evacuated fluid revealed a non typeable Haemophilus influenzae, and IV ceftriaxone and metronidazole was administered. 3. Discussion We describe a case of a 9-year-old child with EH secondary to acute sinusitis, who presented with symptoms of head ache,
S. Aviner et al. / International Journal of Pediatric Otorhinolaryngology 78 (2014) 385–387
386
Fig. 1. (A). A non-contrasted computerized tomography (NCCT) of the brain demonstrated a large epidural hyper-dense collection, most likely a hematoma with entrapped gas bubbles. (B, C). Sagittal and coronal reconstructions of the NCCT of the brain demonstrated signs of bilateral frontal sinusitis (arrow). Notable is the normal subcutaneous fat in the frontal area (arrowhead). Bone destruction or fractures were not found.
abdominal pain, fever, and vomiting. We reviewed the medical literature and have been able to retrieve only 12 more cases of EH ascribed to sinusitis (Table 1). Indeed, two tertiary hospitals did not have any EH among 34 cases of intracranial complication of sinusitis over a ten-year period. [1,2] The rarity of this complication despite the high incidence of sinusitis suggests that some unrecognized factors are involved in its pathogenesis. The importance of rapid diagnosis and treatment of EH could not be overemphasized. Timely diagnosed and surgically treated patients are likely to fully recover, while a delay in diagnosis could result in permanent neurologic impairment, [3] and even death. [4] However, EH often begins as an insidious process, with a few neurologic signs and symptoms leading to delay in diagnosis. Patients might be asymptomatic as the infection is being contained by the dura, [3,5,6] and signs and symptoms are related to the sinusitis. Headache is the most common presenting symptom (12 out of 13 patients) followed by fever (8 patients, Table 1) and these might be the only symptoms. Neurologic symptoms including a decreased consciousness, [4,7–11] nausea and vomiting, [3,6,7,12,13] cranial nerve dysfunction [3,10,13] hemiparesis, [10,11] and seizures, [4] indicated intracranial complication, while symptoms that are related to the primary focus of infection mainly sinus ache may mask the correct diagnosis. These include orbital and periorbital swelling, [5,8,11,12,14] periorbital edema, [5,7] eyelid swelling, [4] strabismus, [7,8] exopthalmus, [5,11] tearing [3], and pain behind the eye. [4] Some patients present with purulent nasal discharge [9,14] and post nasal drip. [12]
EH appears more frequently in older children and young adults; 10 of the 13 patients in this cohort were 9–18 years on presentation. Our case, a 9-year-old boy, is the youngest described. This age distribution may reflect the fact that complications of sinusitis tend to occur more frequently in children than adults. In addition, the lack of EH due to sinusitis before the age of 9 years could be explained by the absence of the frontal sinus in children younger than 7 years, which makes frontal sinusitis a likely cause for EH. In rare cases the sphenoidal or maxillary sinuses may be involved, possibly via the retromaxillary plexus. Indeed, this pattern of sinus involvement is reflected in the preset cohort; 5 patients had pansinusitis, 4- frontal, 3- sphenoidal, and one had maxillary sinusitis (Table 1). EH is frequently infected as were 8 of the 13 hematoma that were reportedly cultured. Polymorphonuclear infiltrates in the leptomeninges suggests that the blood clot was contaminated from the beginning as demonstrated in some cases. [4,12] Alternatively, the hematoma itself is a good medium for bacterial growth and might be secondarily infected. EH complicating sinusitis does not appear to be bacterial specific, with five different organisms cultured from the hematoma. These include Hemophilus influenza [14] Staph aureus [4] Pseudomonas cepacia, [5] Streptococcus milleri [9], and Streptococcus anginosus, [12] each reported in one case. In two cases no organism was found. [6,13] Since these bacteria are usually found in the frontal sinus a drainage of this sinus might be indicated in selected cases.
Table 1 Summary of cases with SEH associated with sinusitis. Author (year)
Age (years)
Sex
Involved sinus
Hematoma location
Organism coltured
Outcome
Comments
Kelly (1968) [14] Ataya (1968) [8] Rajput (1971) [4] Marks (1982) [7] Sakamato (1997) [5] Papadopoulos (2001) [6] Moonis (2002) [3]
11 31 18 31 16 17 21
M M M M F M M
Pan-sinusitis Pan-sinusitis Frontal Pan-sinusitis Maxillary Frontal Sphenoidal
Frontal Frontal Frontal Frontal Frontal Frontal Temporal
Hemophilus influenzae ND Staph aureus ND Pseudomonas cepacia Non coltured ND
Orbital cellulitis
Griffiths (2002) [9]
17
F
Pan-sinusitis
Frontal
Streptococcus milleri
Full recovery Full recovery Died Full recovery Full recovery Full recovery Mild neurologic sequelae Full recovery
Chaiyasate (2007) [12] Takahashi (2010) [10]
14 10
F F
Pan-sinusitis Sphenoidal
Frontal Temporal
Streptococcus anginosus ND
Full recovery Full recovery
Cho (2011) [13] Spennato (2012) [11] Current case
17 12 9
F F M
Sphenoidal Frontal Frontal
Temporal Frontal Frontal
Non coltured ND Hemophilus influenzae
Full recovery Full recovery Full recovery
Congenital high palate & submucous cleft palate Bone defect between temporal base and sphenoid sinus
S. Aviner et al. / International Journal of Pediatric Otorhinolaryngology 78 (2014) 385–387
A contrast enhanced computerized tomography scan is the prefered imaging modality for a rapid diagnosis. A bone window should be carefully reviewed for sinus opacification, bony destruction, or osteomyelitis. MRI may add fine delineation of the structures. Since the signs and symptoms of EH are mild and non specific, detailed history of acute sinusitis (nasal obstruction, facial pain, and headache, purulent nasal discharge and anosmia) and endoscopic evaluation of the nose are important in order to establish the diagnosis of sinus infection. Attention to mild neurologic alterations and prompt imaging studies may lead to early diagnosis and treatment. Two possible mechanisms were proposed to explain the development of EH from a neighboring infection. The first one involves retrograde infection through valveless vessels leading to arteritis, weakening of the vessel wall and rupture. [11] The second assumes that the accumulation of bacterial products as pus, exudate, or air in the extradural space that causes a detachment of dura mater and bleeding. The true mechanism may involve a combination of the two mechanisms. [14] EH may cause a rapid and life threatening neurologic deterioration. A worsening headache or a new neurologic symptom, especially in a patient with a known sinusitis, should encourage the physician to get a CT scan. A rapid diagnosis of EH and prompt surgical intervention are the key factors for a favorable prognosis. 4. Conclusions EH due to sinusitis is a rare but potentially life threatening phenomenon. Presenting symptoms are sometimes minimal or absent and do not differ from those of sinusitis. Any suspected
387
symptom should encourage prompt evaluation by CT scan and immediate treatment to provide the best possible outcome. References [1] J.S. Glickstein, R.K. Chandra, J.W. Thompson, Intracranial complications of pediatric sinusitis, Otolaryngol. Head Neck Surg. 134 (2006) 733–736. [2] C.W. Hicks, J.G. Weber, J.R. Reid, M. Moodley, Identifying and managing intracranial complications of sinusitis in children: a retrospective series, Pediatr. Infect. Dis. J. 30 (2011) 222–226. [3] G. Moonis, A. Granados, S.L. Simon, Epidural hematoma as a complication of sphenoid sinusitis and epidural abscess: a case report and literature review, Clin. Imaging. 26 (2002) 382–385. [4] A.J. Rajput, B. Rozdilsky, Extradural hematoma following frontal sinusitis. Report of a case and review of the literature, Arch. Otolaryngol. 94 (1971) 83–86. [5] T. Sakamoto, K. Harimoto, S. Inoue, A. Konishi, Extradural hematoma following maxillary sinusitis. Case illustration, J. Neurosurg. 87 (1997) 87–132. [6] M.C. Papadopoulos, A. Dyer, C. Hardwidge, Spontaneous extradural haematoma with sinusitis, J. R. Soc. Med. 94 (2001) 588–589. [7] S.M. Marks, M.D. Shaw, Spontaneous intracranial extradural hematoma. Case report, J. Neurosurg. 57 (1982) 708–709. [8] N.L. Ataya, Extradural haematoma secondary to chronic sinusitis: a case report, J. Laryngol. Otol. 100 (1986) 951–953. [9] S.J. Griffiths, N.S. Jatavallabhula, R.D. Mitchell, Spontaneous extradural haematoma associated with craniofacial infections: case report and review of the literature, Br. J. Neurosurg. 16 (2002) 188–191. [10] Y. Takahashi, N. Hashimoto, A. Hino, Spontaneous epidural hematoma secondary to sphenoid sinusitis -case report-, Neurol. Med. Chir. (Tokyo) 50 (2010) 399–401. [11] P. Spennato, D. De Paulis, A. Bocchetti, A. Michele Pipola, G. Sica, R.J. Galzio, Spontaneous intracranial extradural haematoma associated with frontal sinusitis and orbital involvement, Neurol. Sci. 33 (2012) 435–439. [12] S. Chaiyasate, S. Halewyck, K. Van Rompaey, P. Clement, Spontaneous extradural hematoma as a presentation of sinusitis: case report and literature review, Int. J. Pediatr. Otorhinolaryngol. 71 (2007) 827–830. [13] K.S. Cho, W.H. Cho, H.J. Kim, H.J. Roh, Epidural hematoma accompanied by oculomotor nerve palsy due to sphenoid sinusitis, Am. J. Otolaryngol. 32 (2011) 355–357. [14] D.L. Kelly Jr., J.M. Smith, Epidural hematoma secondary to frontal sinusitis. Case report, J. Neurosurg. 28 (1968) 67–69.
