Suppurative otitis media was the most common cause of brain abscesses, which are located preferentially in the temporal lobe of the brain and in the cerebellum.
Ethiopathogenesis
The infection of the encephalic mass is produced by contiguity, previous perforation of the roof of the antrum or the box; due to thrombophlebitis of the lateral sinus, or through the internal auditory canal in cases of labyrinthitis.
Clinical picture
Brain locations are often characterized by a variable headache, sometimes “dull,” and sometimes severe. Later the picture of intracranial hypertension is installed. Localization symptoms appear in abscesses neighboring motor areas. Symptoms in cerebellar abscess can be pure cerebellar (static coordination and gait disorder, muscular hypotonia, hypermetria, and adiadochokinesis) or cerebellum vestibular, when vertigo and nystagmus are added.
Diagnosis
It will be based on the extradural abscess, which does not offer localization signs and is generally not very expressive from the symptomatic point of view; with meningitis, which usually presents a characteristic syndrome and with suppurative diffuse labyrinthitis, which, at times, is difficult to differentiate from a cerebellar abscess.
Treatment
In the encephalitis phase, in which the process is not localized, a surgical approach to the otic focus is recommended, complete with vigorous antibiotic treatment. Once the abscess has passed into the chronic phase and has become cystic, it must be approached neurosurgically.