This document discusses various intracranial complications that can arise from otitis media, including meningitis, epidural abscesses, brain abscesses, and sinus thrombosis. It describes how infection spreads from the middle ear to the brain via direct erosion or along pathways like blood vessels. Symptoms vary from headache and fever in early stages to seizures, neurological deficits, and coma in later stages. Diagnosis involves CT, MRI, and lumbar puncture. Treatment requires antibiotics and often surgical drainage of abscesses.

1. OTOLOGIC INTRACRANIAL
COMPLICATION
SOMNATH SAHA

2. VARRIANTS
 MENINGITIS
 EXTRADURALABSCESS
 SUBDURAL ABSCESS
 SINNUS THROMBOPHELBITIS
 TEMPORAL LOBE ABSCESS
 CEREBELLAR ABSCESS
 OTITIC HYDROCEPHALOS

3. MODE OF SPREAD
 PREFORMED PATHWAYS-FRACTURE
OF TEMPORAL BONE,LABRYNTH,
UNUNITED CRANIAL SUTURES,
VASCULAR FORAMINA,& CONG.
DEHISCENCES
 DIRECT SPREAD-EROSION/OSTEITIS

4. LABRYNTH
 INF-POST FOSSA
 S.A. SPACE
 LOCALISED
ABSCESS IN IAM
 EXTRADURAL
ABSCESS NEAR
ELS

5. I.C.C
 M.E.C
 MENINGES
 ACROSS THE MENINGES
 INVASION OF BRAIN TISSUE

6. WHAT HAPPENED WHEN
MENINGES GET INVOLVED?
 PACHYMENINGITIS DURAL THICKENING &
ADHERENCE TO BONE
 GR. TISSUE FORMATION ON DURA &SUBDURAL
SPACE MAY REACT BY OBLITERATION
 FORMATION OF ED ABSCESS
 LARGE ED ABSCESS MAY PRESENT AS POTTS
PUFFY TUMOUR
 MAY DEVELOP SUBDURAL EMPYEMA

7. MENINGITIS
 MOST COMMON ICC
 SYMPTOM : FEVER,HEADACHE,
VOMITING,ALTERED SENSORIUM
 SIGN :NECK RIGIDITY, POSITIVE
KERNIGS&BRUDZINSKIS SIGN
 INV:C.T,FUNDUS&L.P
 TREATMENT:ANTIBIOTICS &
SURGERY

8. EPIDURAL ABSCESS
SIZE
 ED ABSCESS IN MC FOSSA
 EDA MEDIAL TO ARCUTE EMINENCE
 EDA IN POST. FOSSA
 POTTS PUFFY TUMOUR

9. EPIDURALABSCESS-contd.
 MAY BE SYMPTOMLESS
 HEADACHE
 SYMPTOM IN COMMUNICATING
ABSCESS
 SYMPTOM IN LARGE MCF LESSION
 EDA OVER PETROUS APEX
GRADENIGO SYNDROME
 POST.FOSSA EDA PERISINIOUS ABS.

10. DIAGONOSIS&TREATMENT
OF EDA
 MANY CASES ACCIDENTALLY
DISCOVERED DURING SURGERY
 ENHANCED C.T OR MRI
 TREATMENT SURGICAL DRAINAGE
&ANTIBIOTICS
 IN CASE OF PERISINIOUS ABSCESS
SIGMOID SINUS SHOULD BE
CHEAKED

11. SUDURAL EMPYEMA
 LOCATED BET. DURA &PIA-ARACHNOID
MEMBRANE
 MOST EMERGENT NS CONDITION
 SYMPTOM-SEVERE HEADACHE
&MARKED RISE OF TEMP.
 LEFT SIDE INF APHASIA& PROGRESSIVE
CONIRALATERAL HEMIPARESIS
 PARALYSIS OF CONJUGATE GAZE TO
CONTRALATERAL SIDE/ DEVIATION OF
EYE TOWARDS THE SIDE OF LESSION

12. SUDURAL EMPYEMA-CONT.
 JACKSONIAN SEIZURES
 MARKED NECK STIFFNESS
&PAPILLEDEMA IN POST. FOSSA LS
 IMAGAING STUDIES
CONFIRMATORY
 Tt: IMM. NS DRAINGE& ANTIBIOTICS

13. SIGMOID SINUS
THROMBOSIS
 PATHOLOGY
 SYMPTOM;FEVER,HADACRE&NECK
STIFFNESS
 SIGN:GRESSINGER SIGN ; LILLE _
CROW TEST;TOBEY –AYER TEST
 CT DELTA SIGN
 MR
 TREATMENT

14. BRAIN ABSCESS
MECHANISM OF BRAIN
TISSUE INVASION
 THROMBOPHELBITIS OF LAT.SINUS
 RETROGRADE EXTN. ALONG A
CEREBELLAR VESSEL
 CEREBELLAR THROMBOPHELBITIS
 CEREBELLAR ABSCESS(LST+CA)
 SPT+TLA MAY ALSO OCCUR

15. BRAIN TISSUE INVASION
 PERIVASCULAR
ROUTE THROUGH
VIRCHOW-ROBIN
SPACE
 THROMBOPHELBI
TIS OF
MENINGEAL VS.

16. STAGES OF ABSCESS
FORMATION
 CEREBRAL THROMBOPHELBITIS
 UNCONTROLLED INFECTION ENCEPHALITIS
&BRAIN OEDEMA
 FOCAL NECROSIS &LEQUFECETION
 ABSCESS FORMATION
 ENCAPSULATION

18. FORMATION OF
MULTILOBULAR ABSCESS
 ACUTE ABSCESS
 ENCPSULATION
 CHRONIC ABSCESS
 BREAKAGE OF
CAPSULE
 NEW ABSCESS
FORMATION&
ENPSULATOIN
 FORMATION OF M.L
ABSCESS

20. FATE OF ABSCESS
 CEREBRUM ABSCESS TENDS TO
PROGRESS TOWARDS LATERAL
VENTRICLE MAY RUPTURE
 OVERWHELMING INFECTION OF
VENTRICULAR SYS.&S.A SPACE
 RUPTURE NOT NECESSARILY FATAL
 CEREBELLAR ABSCESS MAY BURST
INTO FOURTH VENTRICLE

21. FATE OF ABSCESS-CONTD
 ABSCESS+OEDEMA
 S.O.L+HYDROCEPHALOS
 COMPRESSION OF LAT. VENTRICLE
 UNCUS DISPLACEMENT
 MID BRAIN COMPRESSION
 OBS. OF CSF FLOW
 FURTHER IN VENTRICULAR PR.
 DEATH DUE TO S,T HYDROCEPHALOS

23. FATE OF UNTREATED
CEREBELLAR ABSCESS
 CEREBELLAR ABSCESS
 MAY DISPLACE FLOCCULAS
 IN FORAMEN MAGNUM
 PODUCES CORKING
 CONSEQUENT FAILURE OF C.V.
&RESPIRATORY CENTRES

24. SYMPTOM &SIGN OF
BRAIN ABSCESS
 THE STAGE OF INVASION
 THE STAGE OF ESTABLISHED DS.
 TERMINAL STAGE

25. STAGE OF INVASION
 EARACHE
 HEADACHE
 NAUSEA &VOMITING
 DROWSINESS
 CHANGE OF TEMP.&PULSE RATE

26. STAGE OF ESTABLISHED DS.
 INCREASE HEADACHE INTENSITY
 PROJECTILE VOMITING
 DROWSINESS MAY PROGRSS TO
COMA
 GIDDINESS
 EPILEPTIC FITS
 APHASIA

27. STAGE OF ESTABLISHED DS.
SIGNS
 NECK RIGIDITY
 PAPILLOEDEMA
 HEMIPLEGIA
 NYSTAGMUS

28. TERMINAL STAGE
 LOW TEMP.&SLOWING PULSE RATE
 CHEYNE-STOKES BREATHING IN A
DEEPLY COMATOSED PT.
 DILATED FIXED PUPILS
 TEMP. &P.R MAY SUDDENLY RISE
BEFORE DEATH

29. MANAGEMENT
 START Tt WITH CL. SUSPICION
 OBTAIN C.T SCAN
 CONSULT NEUROSURGEON
 CONCOMITANT DRAINGE OF BRAIN
ABSCESS &MASTOIDECTOMY
OFFERS BEST PROGNOSIS