Anton Budhi Darmawan1, Ema Shofiana Azkia2. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Jenderal Soedirman-Margono Soekarjo Hospital, Purwokerto, Indonesia. Electronic address: ab.darmawan@gmail.com. 2. Department of Neurosurgery, Faculty of Medicine, Universitas Jenderal Soedirman-Margono Soekarjo Hospital, Purwokerto, Indonesia.
Abstract
INTRODUCTION: Hemiparesis caused by otogenic brain abscess in children is an unusual complication of Chronic Suppurative Otitis Media. Complications can occur when the disease is not treated properly so that the infection in the middle ear spreads intracranially. CASE PRESENTATION: We report a case of Chronic Suppurative Otitis Media with cholesteatoma in a 14-year-old boy with complications of right hemiparesis caused by an otogenic brain abscess. His management included open craniotomy, drainage of the abscess, radical mastoidectomy and intravenous antibiotics according to the result of the culture and sensitivity. CLINICAL DISCUSSION: Commonly, the location of the abscess is closely related to the source of infection. Affected brain lobes usually depend on predisposing factors that cause the development of brain abscesses. In this case, clinical manifestations appear in the form of contralateral hemiparesis even though the source of infection comes from the ear. This can occur due to massive abscesses and the presence of extensive perifocal edema which results in pressure in the subcortex area. The patient underwent radical mastoidectomy in conjunction with an abscess excision craniotomy. CONCLUSION: Hemiparesis caused by an otogenic brain abscess is unusual. Rapid and precise diagnosis and treatment can minimize patient mortality and morbidity.
INTRODUCTION:Hemiparesis caused by otogenic brain abscess in children is an unusual complication of Chronic Suppurative Otitis Media. Complications can occur when the disease is not treated properly so that the infection in the middle ear spreads intracranially. CASE PRESENTATION: We report a case of Chronic Suppurative Otitis Media with cholesteatoma in a 14-year-old boy with complications of right hemiparesis caused by an otogenic brain abscess. His management included open craniotomy, drainage of the abscess, radical mastoidectomy and intravenous antibiotics according to the result of the culture and sensitivity. CLINICAL DISCUSSION: Commonly, the location of the abscess is closely related to the source of infection. Affected brain lobes usually depend on predisposing factors that cause the development of brain abscesses. In this case, clinical manifestations appear in the form of contralateral hemiparesis even though the source of infection comes from the ear. This can occur due to massive abscesses and the presence of extensive perifocal edema which results in pressure in the subcortex area. The patient underwent radical mastoidectomy in conjunction with an abscess excision craniotomy. CONCLUSION:Hemiparesis caused by an otogenic brain abscess is unusual. Rapid and precise diagnosis and treatment can minimize patientmortality and morbidity.