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Simultaneous Orbital and Intracranial Abscesses in 17 Cases
Michael M Park1,2, Osama M Ahmed3, John D Ng4
1Department of Ophthalmology and Visual Science, Yale School of Medicine.
Ophthalmic Plastic and Reconstructive Surgery
|September 15, 2020
Summary
Simultaneous orbital and intracranial abscesses are rare, often spreading from the superior orbit to the frontal lobe, particularly in males. Surgical evacuation and antibiotics are key treatments, with most patients showing improved outcomes.
Area of Science:
- Ophthalmology
- Neurosurgery
- Infectious Diseases
Background:
- Orbital and intracranial abscesses are serious infections requiring prompt diagnosis and management.
- Simultaneous occurrence is exceptionally rare, posing significant diagnostic and therapeutic challenges.
Purpose of the Study:
- To delineate the characteristics of patients with simultaneous orbital and intracranial abscesses.
- To analyze the demographics, clinical presentation, treatment strategies, and outcomes in this rare patient cohort.
Main Methods:
- A historical cohort study was conducted involving 17 patients diagnosed between 2010 and 2018.
- Data collected included patient demographics, abscess location, causative pathogens, treatment interventions, and clinical outcomes.
Main Results:
- The cohort comprised predominantly males (82%), with a mean age of 26.9 years.
- Superior orbital and frontal lobe abscesses were most common (82% and 94%, respectively), frequently associated with concurrent sinus disease (94%).
- Surgical evacuation (94%) and antibiotics targeting Streptococcus and Staphylococcus species were standard; 94% experienced stable or improved mental status and visual function.
Conclusions:
- Simultaneous orbital and intracranial abscesses are rare, with direct spread from superior orbital infections being a likely mechanism.
- Male sex and infections with Streptococcus/Staphylococcus species are potential risk factors for intracranial spread.
- Favorable outcomes may be associated with younger age and absence of seizures or altered mental status at presentation.
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