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KMID : 0829220190430050223
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Korean Journal of Oral and Maxillofacial Pathology
2019 Volume.43 No. 5 p.223 ~ p.230
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Brain Abscess due to Odontogenic Infection : Case Report and Literature Review
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Chang T.-H.
Leem Dae-Ho
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Abstract
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Brain abscesses caused by odontogenic infection are a rare and lifethreatening condition. When dental patients show neurological symptoms such as decreased consciousness, a brain abscess should be considered as a possible diagnosis. We reported that a 65-year-old man visited the emergency room because of left facial edema, high fever, limitation of mouth opening and decreased consciousness. CT, bone scan, and microbiologic examination revealed that the brain abscess originated from left mandibular osteomyelitis with an apical lesion in tooth #36. It was hard to diagnose the location of odontogenic infection. Because there were no evidence of submandibular abscess which is a common path of mandibular posterior infection, early diagnosis was difficult. MRI and radiographs such as facial CT and brain CT revealed procedure that inflammatory findings progressed through the coronoid process, the temporal space, into the subdural space. We compared the present case to previous cases, articles published after the year 2000 in Korea and abroad were investigated. The patient was treated successfully with extraction of causative teeth, drainage surgery, intravenous antibiotics by collaboration between the department of oral maxillofacial surgery and neurosurgery. It is difficult to diagnose brain abscess because central nervous system can be infected by various pathway. As shown in this case, patients with a brain abscess caused by a dental infection should be diagnosed and treated with a multidisciplinary approach.
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KEYWORD
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Brain abscess, Odontogenic infection, Osteomyelitis
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