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A Case of Brain Abscess Caused by Medication-Related Osteonecrosis of the Jaw

Kenji Yamagata1, Hiroki Nagai1, Osamu Baba1

  • 1Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.

Case Reports in Dentistry
|March 8, 2016
PubMed

Insights

Brain abscesses from medication-related osteonecrosis of the jaw (MRONJ) are rare. This case highlights successful treatment of a brain abscess secondary to maxillary MRONJ using antibiotics and surgery.

Area of Science:

  • Oncology
  • Neurosurgery
  • Oral and Maxillofacial Surgery

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is a known complication of bone-targeting therapies.
  • Brain abscesses as a complication of MRONJ are exceptionally rare.
  • Patients with advanced cancer often receive medications that increase MRONJ risk.

Purpose of the Study:

  • To report a rare case of brain abscess secondary to medication-related osteonecrosis of the jaw.
  • To discuss the management and potential preventative strategies for this rare complication.

Main Methods:

  • Case presentation of a 76-year-old male with prostatic carcinoma and maxillary MRONJ.
  • Treatment involved a course of ceftriaxone and metronidazole for the brain abscess.
  • Surgical intervention included sequestrectomy of the infected bone.

Main Results:

  • Successful resolution of the brain abscess was achieved with the combined antibiotic and surgical approach.
  • The patient's maxillary MRONJ was managed, preventing further intracranial spread.

Conclusions:

  • Early and aggressive surgical management, including resection of infected bone, is crucial for maxillary MRONJ extending to sinuses.
  • Prompt identification and treatment of MRONJ-associated brain abscesses are vital to prevent severe neurological sequelae.

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