Maxillary sinusitis complicated by stroke - 10/11/18

Doi : 10.1016/j.anorl.2018.07.004

C. Fabre ^a,^⁎ , I. Atallah ^a,^b,^c, I. Wroblewski ^b,^c,^d, C.A. Righini ^a,^b,^c
^a Service hospitalo-universitaire d’ORL et chirurgie cervico-faciale, CHU Michalon CS 10217, 38043, Grenoble cedex 9, France
^b Faculté de médecine, universités des Alpes, Grenoble, France
^c UGA/UMR/CNRS 5309/Inserm 1209, institut Albert-Bonniot, Grenoble, France
^d Réanimation et surveillance continue pédiatrique, pôle Couple Enfant, CHU de Grenoble, Grenoble, France

^⁎Corresponding author.

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Abstract

Introduction

Neurological complications of acute sinusitis are exceptional, but potentially serious.

Case report

The authors report the case of a 6-year-old diabetic girl who presented with middle cerebral artery ischemic stroke secondary to inflammatory arteritis of the left internal carotid artery in a context of bilateral acute maxillary sinusitis. MRI confirmed ischaemic stroke associated with carotid arteritis and complete obstruction of the maxillary sinuses. A favourable outcome was observed after endoscopic drainage of the sinuses associated with broad-spectrum antibiotic therapy.

Discussion

This complication was probably due to spread of an infectious inflammatory reaction of the intrapetrosal carotid artery and its branches via the pterygoid venous plexus. To our knowledge, this is the first published case report of maxillary sinusitis complicated by stroke.

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Keywords : Diabetes mellitus, Sinusitis, Arteritis, Ischaemic stroke