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A case with intracranial complications caused by paranasal sinusitis, who was also diagnosed with pre-Disseminated Intravascular Coagulation syndrome (pre-DIC). A 21-year-old male had complained of headache, high grade fever, general convulsions and consciousness disturbances. At the first examination his left superior eye lid and cheek were slightly swollen. The emergent CT revealed diffuse soft tissue density in the left ethmoidal, maxillary and sphenoidal sinuses and a low density area in the left frontal lobe. Laboratory examination of blood showed white blood cells increased, platelets decreased and fibrin degenerated products increased. These data suggested a status of pre-DIC. Moreover, analysis of cerebro-spinal fluid suggested bacterial meningitis. In order to control of sinusitis as the primary lesion, endoscopic sinus surgery was performed immediately. Not only intensive chemotherapy but also precise suction removal of the purulent secretion in the sphenoidal sinus under endoscopy were effective for control of inflammation. Nevertheless, the patient's consciousness level and left hemiplegia worsened and a head-CT revealed a subdural abscess. Neurosurgical drainage was successful and the patient returned to normal. Ten weeks after surgery the patient was discharged with no functional disorder. The following examination revealed no trouble in the paranasal sinuses. This case confirmed the usefulness of endoscopic sinus surgery for the treatment of paranasal lesions and the importance of follow-up in cases of intracranial complications.

A Case in the Status of Pre-DIC with Intracranial Complications Caused by Paranasal Sinusitis.