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
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.
18. FORMATION OF
MULTILOBULAR ABSCESS
ACUTE ABSCESS
ENCPSULATION
CHRONIC ABSCESS
BREAKAGE OF
CAPSULE
NEW ABSCESS
FORMATION&
ENPSULATOIN
FORMATION OF M.L
ABSCESS
19.
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
22.
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