Journal of Maxillofacial and Oral Surgery

, Volume 16, Issue 1, pp 58–64 | Cite as

Brain Abscess Potentially Resulting from Odontogenic Focus: Report of Three Cases and a Literature Review

  • Masaya AkashiEmail author
  • Kazuhiro Tanaka
  • Junya Kusumoto
  • Shungo Furudoi
  • Kohkichi Hosoda
  • Takahide Komori
Research Paper



Odontogenic foci can rarely cause intracranial infection. Hematogenous spread is considered to be the most important pathophysiological mechanism of intracranial infection of odontogenic origin. To investigate the oral origin of intracranial infections, oral surgeons should understand the underlying mechanisms by which oral bacteria spread to the central nervous system. However, there have been very few reports of intracranial infection resulting from odontogenic infection.

Case reports

The authors report the cases of a 64-year-old man, a 68-year-old man, and a 64-year-old woman whose brain abscesses perhaps have arisen from odontogenic foci, because other sources of intracranial infection such as endocarditis and maxillary sinusitis were not found. Bacteriological examination of brain abscess specimens identified Staphylococcus aureus in case 1, Streptococcus constellatus, Fusobacterium nucleatum, and Parvimonas micra in case 2, and Lactobacillus catenaformis, Porphyromonas gingivalis, and F. nucleatum in case 3. All suspected causal teeth had no obvious signs of acute inflammation in all three cases.


Oral surgeons should understand these characteristics of odontogenic brain abscess, in which the potentially causal odontogenic foci often lack acute symptoms. If other origins of infection are not found, it would be better to eliminate the potentially causal odontogenic foci for improvement of oral hygiene, however, the decision making criteria to eliminate suspected causal teeth is needed to be elucidated.


Brain abscess Odontogenic foci Magnetic resonance image Drainage 


Compliance with Ethical Standards

Conflict of interest

None declared.


  1. 1.
    Moazzam AA, Rajagopal SM, Sedghizadeh PP, Zada G, Habibian M (2015) Intracranial bacterial infections of oral origin. J Clin Neurosci. doi: 10.1016/j.jocn.2014.11.015 PubMedGoogle Scholar
  2. 2.
    Chandy B, Todd J, Stucker FJ, Nathan CO (2001) Pott’s puffy tumor and epidural abscess arising from dental sepsis: a case report. Laryngoscope 111:1732–1734CrossRefPubMedGoogle Scholar
  3. 3.
    Corson MA, Postlethwaite KP, Seymour RA (2001) Are dental infections a cause of brain abscess? Case report and review of the literature. Oral Dis 7:61–65CrossRefPubMedGoogle Scholar
  4. 4.
    Iida Y, Honda K, Suzuki T, Matsukawa S, Kawai T, Shimahara T, Chiba H (2004) Brain abscess in which Porphyromonas gingivalis was detected in cerebrospinal fluid. Br J Oral Maxillofac Surg 42:180CrossRefPubMedGoogle Scholar
  5. 5.
    Mylonas AI, Tzerbos FH, Mihalaki M, Rologis D, Boutsikakis I (2007) Cerebral abscess of odontogenic origin. J Craniomaxillofac Surg 35:63–67CrossRefPubMedGoogle Scholar
  6. 6.
    Ulivieri S, Oliveri G, Filosomi G (2007) Brain abscess following dental procedures. Case report. Minerva Stomatol 56:303–305PubMedGoogle Scholar
  7. 7.
    Antunes AA, de Santana ST, de Carvalho RW, Avelar RL, Pereira CU, Pereira JC (2011) Brain abscess of odontogenic origin. J Craniofac Surg 22:2363–2365CrossRefPubMedGoogle Scholar
  8. 8.
    Haggerty CJ, Tender GC (2012) Actinomycotic brain abscess and subdural empyema of odontogenic origin: case report and review of the literature. J Oral Maxillofac Surg 70:e210–e213CrossRefPubMedGoogle Scholar
  9. 9.
    Park SY, Suh DW, Park CM, Oh MS, Lee DK (2014) Brain abscess due to odontogenic infection: a case report. J Korean Assoc Oral Maxillofac Surg 40:147–151CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Yang J, Liu SY, Hossaini-Zadeh M, Pogrel MA (2014) Brain abscess potentially secondary to odontogenic infection: case report. Oral Surg Oral Med Oral Pathol Oral Radiol 117:e108–e111CrossRefPubMedGoogle Scholar
  11. 11.
    Ben Hadj Hassine M, Oualha L, Derbel A, Douki N (2015) Cerebral abscess potentially of odontogenic origin. Case Rep Dent 2015:267625PubMedPubMedCentralGoogle Scholar
  12. 12.
    Haymaker W (1945) Fatal infections of the central nervous system and meninges after tooth extraction: with an analysis of twenty-eight cases. Am J Orthod Oral Surg 31:A117–A188CrossRefGoogle Scholar
  13. 13.
    Ewald C, Kuhn S, Kalff R (2006) Pyogenic infections of the central nervous system secondary to dental affections—a report of six cases. Neurosurg Rev 29:163–166 (discussion 166–167) CrossRefPubMedGoogle Scholar
  14. 14.
    Mathisen GE, Johnson JP (1997) Brain abscess. Clin Infect Dis 1997(25):763–779 (quiz 781–781) CrossRefGoogle Scholar
  15. 15.
    Neidert MC, Karlin K, Actor B, Regli L, Bozinov O, Burkhardt JK (2015) Preoperative C-reactive protein predicts the need for repeated intracerebral brain abscess drainage. Clin Neurol Neurosurg 131:26–30CrossRefPubMedGoogle Scholar
  16. 16.
    Corre P, Perret C, Isidor B, Khonsari RH (2011) A brain abscess following dental extractions in a patient with hereditary hemorrhagic telangiectasia. Br J Oral Maxillofac Surg 49:e9–e11CrossRefPubMedGoogle Scholar
  17. 17.
    Greenstein A, Witherspoon R, Leinkram D, Malandreni M (2014) An unusual case of a brain abscess arising from an odontgenic infection. Aust Dent J. doi: 10.1111/adj.12266 Google Scholar
  18. 18.
    Mueller AA, Saldamli B, Stübinger S, Walter C, Flückiger U, Merlo A et al (2009) Oral bacterial cultures in nontraumatic brain abscesses: results of a first-line study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:469–476CrossRefPubMedGoogle Scholar
  19. 19.
    Sun J, Sun J (2014) Intracranial complications of chronic otitis media. Eur Arch Otorhinolaryngol 271:2923–2926CrossRefPubMedGoogle Scholar
  20. 20.
    Penido NO, Chandrasekhar SS, Borin A, Maranhão AS, Gurgel Testa JR (2015) Complications of otitis media—a potentially lethal problem still present. Braz J Otorhinolaryngol. doi: 10.1016/j.bjorl.2015.04.007 Google Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2016

Authors and Affiliations

  • Masaya Akashi
    • 1
    Email author
  • Kazuhiro Tanaka
    • 2
  • Junya Kusumoto
    • 1
  • Shungo Furudoi
    • 1
  • Kohkichi Hosoda
    • 2
  • Takahide Komori
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of NeurosurgeryKobe University Graduate School of MedicineKobeJapan

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