Chronic Headache with recurrent sinusitis - A case study

A young 18yr old boy was brought by his father with chronic frontal headache and symptoms of sinusitis. On examination there was severe tenderness over inner cabthus of lt eye. Localised swelling could be noted over frontal region along with Deviated nasal septum(DNS). Patient was previously advised for Septoplasty. At present headache was severe so we did CT-PNS. To everyones surprise CT was s/o a large fibrolytic lession (? Malignant) was noted over lt Frontal sinus avading orbital plate inferiorly and reacging upto frontal plate of nasal bone. CT guided Diagnostic Biopsy was planned but on Neuro surgeonss opinion Excisional biopsy was considered. Mean while owing to the fear of complete loss of vission and facial disfigurement post operatively patient took DAMA. After not taking any treatment for one month, patient presented with headache and sudden onset convulssions. Immidiate OT was planned to do craniotomy and reduce intracranial pressure. But on opening the cranium targe amopunt of pus was drained. Patient recovered immidaitely and responded well to Antibiotics.