Autogenic Brain Abscess: Conservative or Surgical Treatment. Case Report and Literature Review

Aim: Brain abscesses constitute about 8% of all intracranial lesions. Despite widespread use of antibiotics, brain abscess following chronic suppurative otitis media (CSOM) remains a major problem for the otologist, neurosurgeon, pediatrician, and neurologist. Optimal conservative or/and surgical therapy is still controversial.

Case Presentation: Two cases of otogenic brain abscess in adults (53 and 78 years old) originating from chronic otitis media are presented. The first patient, a 53-year-old man with cholesteatoma of the right middle ear with concomitant brain abscess formation on the ipsilateral temporal lobe, underwent a radical mastoidectomy and 7 days later he was referred to the neurosurgery department for abscess drainage. The second patient, a 78-year-old man with mastoiditis and otogenic brain abscess, underwent a radical mastoidectomy without abscess drainage. One year later the patients remain without any neurological deficits.

Conclusion: Two different approaches of treatment of two similar cases of otogenic brain abscess are presented. Both conservative and surgical treatment of brain abscess were successful.