We have analysed case histories of children with rhinosinusogenic intracranial complications admitted to the ENT department of the Krasnodar regional pediatric hospital for a decade (1994-2003). Of 44 patients, 10 had subdural empyema manifesting primarily with such early symptoms as severe headache (n=5), mental disorders (n=10), fever (9), focal neurological symptoms (n=10). Systemic inflammatory response syndrome occurred in all the children. Preoperative treatment included a complex of measures aimed at correction of vital functions followed by urgent surgical cleansing of the primary and secondary infection foci. Postoperative therapy in a critical unit consisted of combined antibacterial treatment (amoxicilline/clavulanate, oxacilline or vancomycin in combination with cefalosporines of the third generation and metronidasol), infusion and symptomatic therapy. Early diagnosis and treatment including eradication of the primary focus in the paranasal sinuses and drainage of the subdural abscess, antibacterial and infusion therapy provide a good outcome.