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Background <p>Brain abscess is a potentially life-threatening condition typically developing shortly after head trauma or neurosurgery. Delayed onset, particularly more than a decade after the original insult, is exceedingly rare.</p> Case presentation <p>We present the case of a 29-year-old male with a history of frontal bone fractures and cranioplasty in 2011, complicated by a persistently discharging forehead sinus. Fourteen years later, he presented with new-onset seizure and neuropsychiatric symptoms. Imaging revealed a large right frontal abscess with mass effect and midline shift, likely originating from the chronic sinus tract. He underwent urgent surgical drainage, with Staphylococcus aureus isolated from the abscess. The patient improved postoperatively and was managed with long-term intravenous antibiotics and coordinated craniofacial care. </p> Conclusion <p>This case illustrates a rare but serious delayed complication of craniofacial trauma and emphasizes the importance of long-term surveillance in patients with chronic sinus tracts. Clinicians should maintain high suspicion for intracranial pathology in patients with subtle neuropsychiatric symptoms and prior neurosurgical history.</p>

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Silent sinus, explosive outcome: a delayed frontal brain abscess 14 years after cranioplasty

  • 期刊论文

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  • 发表日期：

    2025年6月4日

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  • Ahmed Dahshan,
  • Ahmed Hamdy Youssef,
  • Alaa Ahmed Shalan,
  • Ikhlas Sultan Zayid AlBusaidi,
  • Reem Taha Mohamed Al Maktary,
  • Emad Salah Fathy Salah,
  • Wael Salah Darweesh,
  • Ali Mahmoud Ali Ayoub

摘要

Background

Brain abscess is a potentially life-threatening condition typically developing shortly after head trauma or neurosurgery. Delayed onset, particularly more than a decade after the original insult, is exceedingly rare.

Case presentation

We present the case of a 29-year-old male with a history of frontal bone fractures and cranioplasty in 2011, complicated by a persistently discharging forehead sinus. Fourteen years later, he presented with new-onset seizure and neuropsychiatric symptoms. Imaging revealed a large right frontal abscess with mass effect and midline shift, likely originating from the chronic sinus tract. He underwent urgent surgical drainage, with Staphylococcus aureus isolated from the abscess. The patient improved postoperatively and was managed with long-term intravenous antibiotics and coordinated craniofacial care.

Conclusion

This case illustrates a rare but serious delayed complication of craniofacial trauma and emphasizes the importance of long-term surveillance in patients with chronic sinus tracts. Clinicians should maintain high suspicion for intracranial pathology in patients with subtle neuropsychiatric symptoms and prior neurosurgical history.