Maxillofac Plast Reconstr Surg.  2019 ;41(1):25. 10.1186/s40902-019-0208-2.

Multiple brain abscesses treated by extraction of the maxillary molars with chronic apical lesion to remove the source of infection

• Jung KH
• Ro SS
• Lee SW
• Jeon JY
• Park CJ
• Hwang KG

• KMID: 2468973
• DOI: http://doi.org/10.1186/s40902-019-0208-2

Abstract

BACKGROUND
Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess.
CASE PRESENTATION
A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions.
CONCLUSION
This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

Keyword

Brain abscess; Odontogenic infection; Extraction

MeSH Terms

Abscess
Anesthesia, Local
Anti-Bacterial Agents
Bone Resorption
Brain
Brain Abscess*
Diagnosis
Drainage
Frontal Lobe
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Molar*
Mouth
Neurosurgical Procedures
White Matter
Anti-Bacterial Agents