KOREASCHOLAR

Brain abscesses caused by odontogenic infection are a rare and life-threatening condition. When dental patients show neurological symptoms such as decreased consciousness, a brain abscess should be considered as a possible diagnosis. We reported that a 65-year-old man visited the emergency room because of left facial edema, high fever, limitation of mouth opening and decreased consciousness. CT, bone scan, and microbiologic examination revealed that the brain abscess originated from left mandibular osteomyelitis with an apical lesion in tooth #36. It was hard to diagnose the location of odontogenic infection. Because there were no evidence of submandibular abscess which is a common path of mandibular posterior infection, early diagnosis was difficult. MRI and radiographs such as facial CT and brain CT revealed procedure that inflammatory findings progressed through the coronoid process, the temporal space, into the subdural space. We compared the present case to previous cases, articles published after the year 2000 in Korea and abroad were investigated. The patient was treated successfully with extraction of causative teeth, drainage surgery, intravenous antibiotics by collaboration between the department of oral maxillofacial surgery and neurosurgery. It is difficult to diagnose brain abscess because central nervous system can be infected by various pathway. As shown in this case, patients with a brain abscess caused by a dental infection should be diagnosed and treated with a multidisciplinary approach.

• 장태환(전북대학교 치과대학 구강악안면외과학교실, 임상의학-생명의학연구소) | TH Chang (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, Research Institute of Clinical Medicine-Biomedical Research Institute, Chonbuk National University Hospital)
• 임대호(전북대학교 치과대학 구강악안면외과학교실, 임상의학-생명의학연구소) | DH Leem (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, Research Institute of Clinical Medicine-Biomedical Research Institute, Chonbuk National University Hospital) Correspondence