Abstract
A case of a rhinogenic brain abscess is reported. A 19-year-old male presented with a onemonth history of headache and pyrexia. He also had nausea and vomiting with concomitant progressive decline of initiativity and level of consciousness. CT and MRI scans revealed a huge brain abscess in the left frontal lobe in association with a small amount of pus collection in the epidural space, left frontal-ethmoid-maxillary sinusitis, and a fracture line on the posterior wall of the left frontal sinus. The brain abscess was totally removed with frontal craniotomy following aspiration and external drainage through a burr hole. The left frontal-ethmoid-maxillary sinuses were treated by endoscopic sinus surgery. The patient recovered without neurological deficit. Infection seemed to have spread directly from the frontal sinus to the intracranial space through the bone defect in the posterior wall of the frontal sinus and a tear in the underlying dura mater, both of which were probably the result of a previous head injury.
