Brain Abscess and Dental Infections: a review

Abstract

Odontogenic infections may cause brain abscesses. Although infrequent, infections can lead to development of aggressive brain lesions that may be life-threatening for patients. With the advent of new antibiotic treatments, dental abscesses appear to be under control but all patients with high risk of brain abscess should be assessed and treated properly. Hereby, we present an overview of the information available in the literature of the relationship between brain and dental abscesses.

Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

“…Steroids are generally not indicated except in patients with life-threatening cerebral edema and mass effects, neurological deterioration, and meningitis symptoms. [38,39] Epileptic seizures occur in 25% to 50% of patients with brain abscesses. [42] Anticonvulsant treatment for 5 years was indicated for all patients with brain abscesses.…”

“…Antiepileptic drugs may be discontinued if the patient is seizure-free for ≥ 2 years after surgery and electroencephalography does not show epileptic activity. [39] Optimal management typically requires a combination of antibiotic therapy and surgery. Surgical treatment includes minimally invasive techniques, such as biopsy and drainage using stereotactic techniques or CT-guided biopsy and drainage.…”

“…[24] The typical finding of a brain abscess on CT or MRI is a hypodense lesion with a contrast-enhanced ring around the abscess. [39] Other imaging tools used to diagnose brain abscesses include diffusion-weighted imaging and proton magnetic resonance spectroscopy, which allow the differentiation of brain abscesses from cystic tumors. [13] If an odontogenic cause of brain abscess is suspected, a pantomogram or cone-beam CT should be performed to exclude potential foci of infection in the oral cavity.…”

“…CT facilitates early detection, accurate localization, and accurate characterization and determination of the number, size, and staging of abscesses. [39] It also detects hydrocephalus, elevated ICP, edema, and associated infections such as subdural empyema and ventriculitis. Thus, it helps in treatment planning, assessment of treatment adequacy, and sequential follow-up.…”