Spontaneous epidural hematoma secondary to sphenoid sinusitis

Abstract

Epidural hematoma is typically caused by direct head trauma. Spontaneous epidural hematoma can be caused by infections of adjacent regions, vascular malformations of the dura mater, and disorders of blood coagulation. A 10-year-old girl with no history of head injury presented with complaints of headache and fever. On arrival at our hospital, her Glasgow Coma Scale score was 13 and neurological examination revealed right oculomotor palsy and left hemiparesis. Computed tomography (CT) showed an epidural hematoma in the right temporal base. Preoperative angiography identified no specific vascular lesions. Removal of the hematoma was undertaken immediately. Retrospective evaluation of the preoperative CT revealed sphenoid sinusitis and a bone defect between the temporal base and the sphenoid sinus. The epidural hematoma was probably caused by the spread of inflammation from the sphenoid sinus. Sphenoid sinusitis is one of the possible causes of acute epidural hematoma, especially if no traumatic episodes or risk factors can be identified.