Discussion

Otogenic brain abscess is a very dangerous and lethal complication of chronic suppurative otitis media. Most cases of brain abscess usually do have a cholesteatoma in the middle ear or mastoid cavity [6-8]. However, in some cases a brain abscess due to otogenic infection without a cholesteatoma has been reported [3, 9, 10]. In our case we couldn't find any cholesteatoma in the middle ear or mastoid cavity. There was only severe osteitis and polypoid degeneration of the mucosa. The diagnosis of cerebral abscesses remains a difficult problem. Most of the patients have symptoms of increased intracranial pressure, which may be followed by impaired consciousness and papillary oedema. Focal neurological abnormalitites and epilepsy may frequently be seen. In only about half of the cases do patients have evidence of infection, such as fever or neck stiffness [4, 7]. For years it has been recognised that some brain abscesses are due