Intracranial Epidural Abscess in a 9-Year-Old Boy With Precocious Puberty and Use of Continuous Positive Airway Pressure.
Wendy S EdlundNeil PatelDavid DeLoneSuresh KotagalPublished in: Journal of child neurology (2020)
Intracranial extension of rhinosinusitis is rare in children. We report a 9-year-old immunocompetent boy with central precocious puberty and obstructive sleep apnea-hypopnea syndrome who developed an intracranial epidural abscess secondary to rhinosinusitis while on continuous positive airway pressure (CPAP) treatment. A retrospective review of the medical record and imaging studies was performed. MEDLINE and Cochrane databases were searched for reports of epidural abscess developing in patients receiving CPAP treatment or in patients with precocious puberty. Intracranial extension of frontal rhinosinusitis is more common during puberty probably because of the active growth of the frontal sinuses and their rich blood supply. Controlled studies show no increase with rhinosinusitis in adults on CPAP; no published studies assess intracranial extension of rhinosinusitis in CPAP use. Patients with unexplained, severe headache and fever following CPAP use may require neuroimaging (magnetic resonance imaging [MRI] / contrast computed tomography) to rule out intracranial extension of sinusitis.
Keyphrases
- positive airway pressure
- obstructive sleep apnea
- sleep apnea
- magnetic resonance imaging
- computed tomography
- optic nerve
- spinal cord
- contrast enhanced
- healthcare
- young adults
- working memory
- functional connectivity
- emergency department
- high resolution
- systematic review
- case control
- positron emission tomography
- randomized controlled trial
- machine learning
- photodynamic therapy
- early onset
- rare case
- artificial intelligence
- deep learning