下顎の歯性感染症から継発した脳膿瘍の１例

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  • A case of brain abscess secondary to mandibular odontogenic infection
  • カガク ノ シセイ カンセンショウ カラ ケイハツシタ ノウ ノウヨウ ノ 1レイ

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We report a rare case of brain abscess secondary to mandibular odontogenic infection. A 50-year-oldman developed an abscess of the infratemporal fossa, masticatory myositis, and temporal myositis caused bylower first molar marginal periodontitis. Incision and drainage were performed by an intraoral approach, andantibiotics were administered intravenously. On the 8th disease day, vomiting occurred, but responded to anantiemetic drug. On the 9th disease day, extraction of lower first molar and adrasion was performed, resulting inthe alleviation of local symptoms. However, a persistent headache occurred, CT and MRI scans revealed a brainabscess and subdural abscess in the temporal lobe, immediately above the skull internal base. The patient wasgiven a diagnosis of brain abscess caused by odontogenic infection. The abscess almost disappeared after conservativetherapy administered at the department of brain surgery, and no sequelae were noted. The abscess apparentlyexpanded directly and continuously from the skull base through the foramen ovale and foramen spinosum.This case emphasizes the need to diagnose brain abscess and subdural abscess as complications of odontogenicinfection.

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