Intracranial complications of pediatric sinusitis are rare but potentially life 
threatening. These complications include cavernous sinus thrombosis, orbital 
infection, meningitis, and subdural empyema. Children with these complications 
may experience significant morbidity from their infection. In such cases, delay 
in diagnosis and treatment may lead to severe brain damage or death. Emergency 
physicians, pediatricians, and otolaryngologists should maintain a high index of 
suspicion for this complication of disease when treating patients with sinusitis 
in the emergency department or outpatient clinic. Early and accurate diagnosis 
of subdural empyema will lead to prompt treatment and a favorable outcome for 
the patient. We report a case of subdural empyema secondary to frontal sinusitis 
in an otherwise healthy immunocompetent adolescent boy.