0:00

Up until now, I've emphasized the

0:05

extra axial complications of sinusitis

0:09

because of the potential for direct spread intracranial.

0:14

One may have an abscess

0:16

that occurs in the parenchyma of the brain.

0:19

This is an example of a patient

0:21

who had an intracranial abscess secondary to

0:24

senno immortal sinusitis.

0:26

Now, the patient may in fact have a

0:29

epidural abscess that leads

0:32

to the intracranial intraparenchymal abscess.

0:35

But in this case, this was in the brain substance itself

0:38

from the ethmoidal sinusitis.

0:41

Here's another example from an article I wrote on imaging

0:46

of Cy nasal inflammatory disease.

0:47

Again, somewhat dated. This is 30 years ago.

0:51

But even on this MR study, you see that this patient had

0:55

parenchymal abnormalities associated

0:57

with hemorrhage on the T one wayed scan infection on

1:01

the T two wayed scan.

1:03

And this meningo encephalitis with brain

1:07

infarction brain hemorrhage associated

1:10

with the meningeal enhancement of the meningo encephalitis.

1:15

This is the other example of vascular complications.

1:18

We've already talked about cavernous sinus thrombosis

1:21

and vasculitis, but one of the potential complications of

1:25

sinusitis that is

1:28

a potential vascular lesion is the development

1:31

of a pseudo aneurysm in this case in the left carotid artery

1:36

secondary to the infiltration of the cavernous sinus.

1:39

So this is a basically a narrowed

1:42

left internal carotid artery from the

1:44

vasculitis of the infection.

1:45

And then we have the pseudo aneurysm formation,

1:48

which obviously can lead to intracranial hemorrhage.

1:51

If it's localized to the cavernous sinus,

1:54

we may have a direct cavernous carotid fistula type one

1:58

with a direct communication

1:59

between the internal carotid artery and the cavernous sinus

2:03

and leading to fistula formation.

2:05

So these are some of the vascular complications

2:08

that one can have with sinusitis.

2:10

And as I mentioned, we've already discussed some of the

2:14

examples where you have filling defects within the cavernous

2:18

science, representing partial thrombosis

2:21

of the cavernous science with an associated

2:24

carotid arteritis.

2:26

I.