OTOGENIC BRAIN ABSCESS

Benisha Julian

Route of Spread

Tegmen plateTemporal bone

Cerebellum

Superior P

etrosal Sinus

Sigmoid Sinus

Posterior Semicircular Canal

Trautmann’s Triangle

Retrograde Thrombophlebitis

Bacteriology• Staph. aureus & albus• Strep. pyogenes• Pneumoccus• E. coli• B. proteus

1 2

3 4

Stages

Initial Encephalitis Stage

1

Headache

Chills

Nausea and vomitting

Clinical features of

Latent Stage

2

Localization of abscess1- 2

weeks

Headache

Raised temperature

Clinical features of

Expanding Abscess Stage3

Expansion of abscess

Raised Intracranial

tension

Clinical features of Intracranial Tension

Headache

Pulse rate & Irregular breathing

Projectile Vomiting

Raised temperature

Papilledema

Terminal Stage

4

Rupture of AbscessInto ventricle

Temporal Lobe AbscessClinical features of

Aphasia

Oculomotor palsy

Hemiplegia

Homonymous Hemianopia

Clinical features ofCerebellar Abscess

Ataxia

Nystagmus

Dysdiadochokinesia

Past pointing

Investigations• CT - diagnostic• Lumbar Puncture• Electroencephalography• Intra-cranial angiography

Temporal lobe

Abscess

Cerebellar Abscess

Treatment•Antibiotics

• Abscess Drainage

•Mastoidectomy – removal of primary focus

of infection