- about 2% as common as brain tumours are but can look similar. More likely it’s a tumour not an abscess
- 2:1 male:female
- about 35% contiguous spread from craniofacial sites (think ears and sinuses)
- about 90% of cerebellar abscesses are otic in orgin
- about 25% post-trauma/surgical
- about 25% haematogenous (think valves/lung abscess)
- haematogenous spread usually in MCA distribution which makes sense given the anatomy and the flow
- the rest (about 15%) have no obvious cause
- >50% mixed flora; lots of anaerobes
- fever in <50%
- headache earliest symptom
- focal signs and ataxia common (just like tumours)
- seizures in 30%
Go forth and diagnose…
Reference:
Harwood-Nuss Clinical Practice of Emergency Medicine, 5th Ed, LWW 2010 p888
Nice to see Harwood and Nuss getting a workout already!
yeah i like it so far. it’s my first proper textbook that isn’t the oxford handbook of EM!