Otogenic cerebral abscess: description of 3 cases, clinical and therapeutic considerations

The authors use the 3 cases of otogenous cerebral abscess which came under observation as starting point for a discussion of the main etiopathogenetic, microbiological, clinical-diagnostic and therapeutic aspects of this disorder. After a brief presentation of the data regarding incidence, preferential localization and age of onset, they discuss the means for intracranial spread of infection and the related symptoms. As regards diagnosis, the authors assert that clinical examination and imaging techniques--CT and especially MRI--enable one to determine the dimension and site of the abscess cavity, differentiating it from other intracranial lesions and to monitor clinical evolution and response to therapy. After mentioning the principle bacteria involved in infection, they deal with the various means of treatment. The authors favor surgical removal of the auricular phlogistic focus and medical treatment of the intracranial abscess. They resort to neurosurgery only in those cases which do not respond to drug treatment or when the size and particular location of the abscess threaten the patient's life. In conclusion, the authors underline the problems seen today in diagnosis and therapy, comparing the quoad vitam and quoad valetudinem prognosis for the affected patients.