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Abstract:

Abcess of the brain is a rare but very dangerous and life-threatening disease. Local spreading from a dental origin of a cerebral abscess and subdural empyema has only sporadically been reported in literature. This case reports the medical history of a 48-year old man with unilateral left facial swelling, who developed a paresis of the left nervus ocu-lomotorius and right hemiparesis after six days of hospitalisation because of a locally spreading dental abscess, complicated by hemorrhagic transformation and subdural empyema. The causal teeth were extracted and incision as well as drainage of the abcess with a tracheotomy were performed. Systemic high-dose antibiotics were started. After the diagnosis of an increasing subdural empyema, responsible for progressive neurological deterioration, a craniotomy was performed, evacuating the empyema. After four weeks of recovery, the patient was transported to a specialised recovery-center. This case report updates the current literature on cerebral abscesses of odontogenic origin.