ABSTRACT
This review was based on 26 cases of brain abscess complicating middle ear infection, admitted at the E.N.T. and Neurosurgery Departments of Assiut University Hospital from January 1988 to February 1990. The youngest patient was 7 years old and the oldest was 64 years old. 12 cases [46.15%] were below 15 years of age. The sex incidence was 16 males [61.54%] and 10 females [38.46%]. 14 cases [53.85%] presented with temporal lobe abscess and the remaining 12 [46.15%] with cerebellar abscess. The source of infection was acute mastoiditis in 2 cases and chronic suppurative otitis media in the remaining 24 patients. None of the abscesses proved to be sterile and the organisms grown included staphylococci, streptococci, proteus and E. coli. Patients with cerebellar abscess were treated with primary excision after C.T. localization. Patients with temporal lobe abscess were treated with burr hole aspiration. Proper mastoid operation was done directly following neurosurgical treatment. The 2 mortalities were due to cerebellar abscess. These 2 cases [7.8%] were admitted with dilated fixed pupils and signs of cerebellar coning. All patients with temporal lobe abscess including cases with advanced neurological manifestations survived. The computed tomographic brain scanning and the increasing experience in its use have increased the ease and accuracy of diagnosis and follow-up of such lesions and have evidently contributed significantly to reduction of mortality