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Abscess-a rare fourth ventricular mass

N Pruthi1, B I Devi, J J Shivshankar

  • 1Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. pruthi_nupur@yahoo.co.in

Acta Neurochirurgica
|October 2, 2007
PubMed

Insights

Posterior fossa abscesses are rare in young adults, often mimicking tumors. This case highlights an abscess in the fourth ventricle linked to chronic otitis media and sinus thrombosis, emphasizing unusual presentations.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Midline posterior fossa masses in young adults typically include medulloblastomas, pilocytic astrocytomas, haemangioblastomas, and ependymomas.
  • Differentiating these tumors from infectious or inflammatory lesions is crucial for appropriate management.

Observation:

  • A rare case of an abscess within the fourth ventricle is presented.
  • The abscess was associated with right chronic suppurative otitis media.
  • Concurrent right transverse sinus thrombosis was noted.

Findings:

  • Clinical, imaging, and intraoperative findings confirmed the fourth ventricle abscess.
  • The association with otitis media and sinus thrombosis suggests a potential contiguous spread or thrombophlebitic pathway.
  • Pathogenesis of intraventricular abscess secondary to otomastoiditis and sinus thrombosis is discussed.

Implications:

  • This case expands the differential diagnosis for posterior fossa masses in young adults.
  • Highlights the importance of considering infectious etiologies, even with mass-like appearances.
  • Underscores the potential complications of untreated chronic otitis media, including intracranial spread and thrombosis.

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