Nontraumatic pneumocephalus and subarachnoid hemorrhage case: Brain abscess re-lated to complicated otitis media

Year 2023, Volume: 40 Issue: 2, 423 - 425, 19.07.2023

Fatih Cemal Tekin , Fatma Selcen Öcal , Mahmut Sertdemir

https://izlik.org/JA66SJ48DG

Abstract

We wanted to present this case to emphasize that the diagnosis of complicated otitis media should be kept in mind in patients brought to the emergency department with headache, nau-sea, vomiting and confusion.
Our case was a 30-year-old male patient. Although he was on oral treatment for otitis media, his symptoms persisted and headache started. CT scan of the brain performed in the emergen-cy room revealed no pathology. Five days later, pneumocephalus and surrounding subarach-noid hemorrhage were detected on brain CT imaging due to nausea, vomiting, headache and confusion. The patient was discharged on the 70th day after medical treatment.
As seen in our case, it should be kept in mind that pneumocephalus in an unconscious patient may occur due to non-traumatic causes and may be a consequence of Complicated Otitis Me-dia and this situation should be investigated meticulously.

Keywords

Intracranial abscess , complications , lateral sinus thrombosis , suppurative otitis media , temporal abscess

References

• 1. Arıncı K, Elhan A. Duyu Organları. Anatomi. 2. 4 ed: Güneş Kitabevi; 2006. p. 370-80.
• 2. Limb CJ, Lustig LR, Durand ML. Acute otitis media in adults: Uptodate; 2022 [Available from: https://www.uptodate.com/contents/acute-otitis-media-in-adults?search=otitis%20media&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=1.
• 3. Danishyar A AJ. Acute Otitis Media StatPearls Publishing 2022 [Available from: https://www.ncbi.nlm.nih.gov/books/NBK470332/.
• 4. Mills R, Hathorn I. Aetiology and pathology of otitis media with effusion in adult life. The Journal of Laryngology & Otology. 2016;130(5):418-24.
• 5. Rijk MH, Hullegie S, Schilder AGM, Kortekaas MF, Damoiseaux RAMJ, Verheij TJM, et al. Incidence and management of acute otitis media in adults: a primary care-based cohort study. Family Practice. 2021;38(4):448-53.
• 6. Govea-Camacho LH, Pérez-Ramírez R, Cornejo-Suárez A, Fierro-Rizo R, Jiménez-Sala CJ, Rosales-Orozco CS. Diagnosis and treatment of the complications of otitis media in adults. Case series and literature review. Cirugía y Cirujanos (English Edition). 2016;84(5):398-404.
• 7. Özünlü A, Gerek M, Satar B, Aktaş D, Dündar A. Yetişkinlerde seröz otitis media etyopatognezi. Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi. 1996;4(2):103-9.
• 8. Lee EJ, Kim RO, Lee M, Joo BE. Concurrent Spontaneous Pneumocephalus and Subarachnoid Hemorrhage Due to Klebsiella Pneumoniae Meningitis. Journal of clinical neurology (Seoul, Korea). 2022;18(2):253-5.
• 9. Adesokan MA, Akbari AR. Cerebrospinal fluid xanthochromia in acute bacterial meningitis as a red herring for subarachnoid haemorrhage: A case report. African Journal of Clinical and Experimental Microbiology. 2022;23(4):442-5".
• 10. Sunnychan S, Deshmukh P, Gaurkar SS, Panicker A, Vijayappan A. Otogenic Brain Abscess: Judicious Management in a Case of Chronic Suppurative Otitis Media. Cureus. 2022;14(10):e30430.
• 11. Schwaber MK, Pensak ML, Bartels LJJTL. The early signs and symptoms of neurotologic complications of chronic suppurative otitis media. 1989;99(4):373-5.
• 12. Lu C-H, Chang W-N, Lui C-C. Strategies for the management of bacterial brain abscess. Journal of Clinical Neuroscience. 2006;13(10):979-85.
• 13. de Louvois J, Gortavai P, Hurley R. Bacteriology of abscesses of the central nervous system: a multicentre prospective study. British Medical Journal. 1977;2(6093):981.
• 14. Duarte MJ, Kozin ED, Barshak MB, Reinshagen K, Knoll RM, Abdullah KG, et al. Otogenic brain abscesses: A systematic review. 2018;3(3):198-208.
• 15. Yağız R, Adalı MK, Taş A, Uzun C, Koten M, Karasalihoğlu A. Kronik Süpüratif Otitis Mediaya Bağlı Kafa İçi Komplikasyonları. Balkan Medical Journal. 2008;25(3):196-203.