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Neurosurgical implications of Pott’s puffy tumor in children and adolescents

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Abstract

Introduction

Pott’s puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis. PPT is potentially severe and can lead to life-threatening intracranial complications.

Patients and methods

The authors present a series of six pediatric patients diagnosed with PPT and intracranial complications between 1999 and 2012. There were five boys and one girl, and the mean age at diagnosis was 11.8 years. All patients presented with frontal swelling, headache, and fever. Two patients had lowered level of consciousness and severe hemodynamic instability.

Results

All patients had epidural abscess, and one also presented subdural empyema. Five patients underwent drainage of all associated abscesses, bone resection, and sinusitis treatment. One was treated conservatively with broad-spectrum antibiotics, and no surgical intervention was required. All patients fully recovered their neurologic status, without further complications.

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Authors and Affiliations

  1. Section of Pediatric Neurosurgery, Department of Pediatric Surgery, Fernandes Figueira National Institute for Health of Woman, Child and Adolescent, Oswaldo Cruz Foundation (IFFFiocruz), Av. Rui Barbosa, 716, 22250-020, Rio de Janeiro, RJ, Brazil

    J. Francisco Salomão, Tatiana Protzenko Cervante & Antonio R. Bellas

  2. Department of Radiology, Fernandes Figueira National Institute for Health of Woman, Child and Adolescent, Oswaldo Cruz Foundation (IFFFiocruz), Rio de Janeiro, RJ, Brazil

    Márcia C. B. Boechat

  3. Section of Infectious and Parasitic Diseases, Fernandes Figueira National Institute for Health of Woman, Child and Adolescent, Oswaldo Cruz Foundation (IFFFiocruz), Rio de Janeiro, RJ, Brazil

    Sheila M. Pone & Marcos V. S. Pone

  4. Department of Neurosurgery, Salgado Filho Municipal Hospital, Rio de Janeiro, RJ, Brazil

    Bernardo de A. Pereira

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  1. J. Francisco Salomão
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  2. Tatiana Protzenko Cervante
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  3. Antonio R. Bellas
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Correspondence to J. Francisco Salomão.

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Salomão, J.F., Cervante, T.P., Bellas, A.R. et al. Neurosurgical implications of Pott’s puffy tumor in children and adolescents. Childs Nerv Syst 30, 1527–1534 (2014). https://doi.org/10.1007/s00381-014-2480-x

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  • DOI: https://doi.org/10.1007/s00381-014-2480-x

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