A 49-year-old male was brought to the Emergency Department after being found 
unresponsive. The patient had multiple seizures and was intubated in the 
prehospital setting. A computed tomography scan showed bilateral paranasal sinus 
disease, and magnetic resonance imaging showed a right frontal abscess and 
subdural empyema. Neurosurgery took the patient to the operating room, performed 
a craniotomy, and drained a large amount of purulent fluid. He was subsequently 
discharged for acute rehabilitation. Clinicians should consider complicated 
frontal sinusitis, especially in the undifferentiated patient presenting with 
neurologic deficits and signs or symptoms of sinus disease.