BRAIN ABSCESS OF AURAL ORIGIN

Abstract

ALTHOUGH braini abscess is by no means a rare complication of suppurative otitis media it is sufficienltly uncommilon to make the report of such cases a matter of interest. The following are brief summaries of six cases that have been under miiy care durinig the past year. Thlee have recovered completely, one died of a recur-rence three montlhs after operatiol, alnd two died without the abscess being found at gperation. CASE I. A man, aged 37. He had had left otitis media for many years with offensive discharge and granulation tissue. He was admitted to the Ministry of Pensions Hospital, Liverpool, on October 28th, 1923, in a drowsy, semiconscious state. When first seen by me on November 2nd he was comatose; temperature 970, pulse 40; tongue dry and furred; no eye symptoms. Operation.-The skull was opened through the squiamous temporal and half an ounce of fetid pus evacuated from the temporosphenoidal lobe. During the operation respiration ceased for about half a minute and was not resumed until the abscess had been opened. Uninterrupted recovery followed, and on December 27th he was able to go home for a few days. On January 25th, 1924, a radical mastoid operation was performed. On February 25th he complained of headache and vomited, and a few hours later became comatose with right-sided convulsions and died. Post-mortem examination revealed a large recurrence in the temporo-sphenoidal lobe. The fatal termination was a great surprise to all, since up to the day of his death the temperature and pulse were normal and the man was going about apparently in good health. On retrospect, symptoms that might have aroused suspicion were slight headache, taciturnity, slowness in answering questions, and a certain moodiness and unsociability.