Otitis media infection invades beneath the dura mater, causing necrosis of part of the arachnoid membrane and pia mater, leading to abscess formation. This condition is difficult to localize and easily spreads into diffuse meningitis, often resulting in death, making it relatively rare in clinical practice.

bubble_chart Clinical Manifestations

The disease progresses rapidly, with high fever, headache, etc. Delirium and hemiplegia may appear 24 hours after onset, followed by unconsciousness and death within 48 hours. According to Bannister's report, one-fourth of the patients died within 48 hours of hospitalization.

bubble_chart Diagnosis

This disease is easily confused with brain abscess and meningitis. It is best to perform cerebral angiography and brain CT scans, which can reveal space-occupying abscesses and areas of vascular compression in the hemisphere.

bubble_chart Treatment Measures

In addition to high-dose antibiotic treatment, mastoidectomy should be performed to remove the lesion. The abscess cavity can often be accessed through the destroyed mastoid bone, with surrounding granulation tissue curetted to expand drainage. If the abscess is extensive, a craniotomy should also be performed externally to the mastoid, removing large bone flaps and incising the dura mater, or multiple cranial trephination drainage procedures may be conducted. According to Bannister's statistics, the cure rate of craniotomy with osteoplastic flaps is higher than that of multiple cranial trephination drainage. Currently, the mortality rate of this condition remains significantly higher than that of brain abscesses.