Development of Posttraumatic Frontal Brain Abscess in Association with an Orbital Roof Fracture and Odontogenic Abscess: A Case Report

We report the case of a 40-year-old transgender female with a frontal abscess presenting several weeks following a motor vehicle crash from which she suffered multiple facial fractures. The patient had multiple right sided facial fractures, including a medial orbital wall fracture and a right sphenoid fracture extending into the superior orbital roof. CT also demonstrated notable hemorrhage in the right frontal lobe. Communication with the ethmoid sinuses likely provided a conduit for bacterial spread through the orbit and into the intracranial and subdural spaces. We discuss the surgical approach for evacuation of the abscess and reconstruction of the skull base with repair of cerebrospinal fluid leak ([Figs. 1] and [2]).

Fig. 1 Three-dimensional reconstruction of CT of the face which reveals the complex facial fractures as well as the right-sided orbital fractures.

Fig. 2 Intraoperative picture showing dural tear at the anterior skull base overlying the orbital roof fracture.

Publication History

Article published online:
01 February 2023