Changing concepts in the management of otitic intracranial infection: use of computerized axial tomography in early detection and monitoring of cerebritis.

The pathogenesis and course of intracranial inflammatory disorders of otitic origin have been studied extensively in the past by clinical, surgical, and morbid means. The recent contribution by CT scanning cannot be overestimated as a modality for identification of the pathologic process. Its use for early detection and monitoring of a clinically suspected intracranial complication of otitic suppurative disease is documented for the first time in this report. Cerebritis or encephalitis as the early manifestation of impending brain dissolution can be identified and followed during specific antibiotic therapy. The proper timing for surgery to remove the otitic focus is enhanced. A review of the literature and a case report illustrate this contribution.