Abstract Listings 2024

Purpose

To describe a series of cases of orbital cellulitis resulting in intracranial complications

Methods

Case series

Results

A retrospective review of patients younger than 18 years old who presented with orbital cellulitis between 2018 and 2023 was performed. Of 41 patients with orbital cellulitis, 5 were identified with intracranial complications including one case of epidural abscess, one case of frontal bone osteomyelitis, one case of empyema, and one case of bilateral cavernous sinus thromboses. Three of these cases had concomitant meningitis. Also, in one particularly severe case, a patient developed contralateral cavernous sinus thrombosis, contralateral superior ophthalmic vein thrombosis, and an ipsilateral ophthalmic artery occlusion that was thought to be related to cerebral vasospasm and treated with intraarterial verapamil during a diagnostic angiogram. The average length of stay for these patients was 12.5 days. Each patient required surgery, with 4 out of 5 requiring an approach addressing both the orbit and sinuses, and 1 out of 5 requiring neurosurgery involvement. All patients required antibiotics on discharge for an average duration of 35 days, with all but one requiring intravenous antibiotics. 3 patients had complete resolution, while 2 had only partial resolution, resulting in visual field defects, extraocular movement restriction, and further longstanding neurologic complications unrelated to the eye.

Conclusion

Intracranial complications of orbital cellulitis are rare but severe and can be life threatening. The condition is more common in pediatric populations and can rapidly progress, requiring appropriate diagnostic workup and prompt medical and surgical management to preserve visual and neurological function.

Additional Authors

↑ Back to top