oa A case of brain abscess in a child following trivial head injury

Introduction: Brain abscess is caused by inflammation and collection of infected material, coming from local or remote infectious sources, within the brain tissue. The infection may also be introduced via a breach in the skull following head trauma or surgical procedures. Brain abscess may also be associated with congenital heart disease in the young children. Here we would like to describe a case of brain abscess secondary to seemingly trivial head injury.

Case presentation: A 12 years old boy presented with left forehead and periorbital swelling for one week with fever, vomiting and headache. Parents added the history of confusion. No history of seizures or LOC was recorded. There was history of minor scalp trauma to the forehead 10 days prior. Examination reveals a febrile child with GCS of 13. Rest of systemic examination was unremarkable. Local examination showed warm tender fluctuant swelling. CT examination was ordered and it revealed, frontal subgaleal collection involving the frontal sinus and extending into intracranial portion. He was admitted for decompressive craniotomy and evacuation of intracranial empyema. The patient's condition improved gradually and was discharged with full recovery after 15 days post-admission.

Discussion: Minor scalp trauma serving route of intracranial infection is a rare complication documented in the literature. Detailed history is important as patient or family may not remember it.