THE clinical and pathologic aspects of otogenic abscesses of the brain have already been widely and thoroughly discussed. Among the various pathologic conditions which may cause them, deep epidural abscesses resulting from perilabyrinthine suppurations deserve particular interest. This is seen clearly in the 3 cases reported in this paper, in which the abscesses showed unusual diagnostic and pathogenetic features. All the cases ended fatally, and the brain and temporal bones were available for histologic examination.
REPORT OF CASESCase 1.\p=m-\W. B., a man 25 years old, was admitted to the Neurological Institute of New York on Aug. 30, 1938. At the age of 8, he had suffered from right-sided acute otitis media following scarlet fever, with discharge from the ear for one week. Since that time he had not had any complaints regarding his ear.In January 1938, he had severe bilateral frontal headaches off and on for one week. In May 1938, he had similar headaches for one week, together with a gradually developing weakness of the left arm and leg, which ceased after a few days. The temperature was elevated to 105 F. during this episode and was associated with delirium and incontinence. Five days before admission the patient began to have similar bouts of headaches, more pronounced on the right side and radiating back to the neck. The first few days the temperature was elevated to 100 to 102 F. Physical Examination.--The general physical examination did not show any abnormal findings. The neurologic examination showed an inconstant slight hyperreflexia of the left upper and lower extremities ; the abdominal reflexes on the left side were less pronounced than the ones on the right. There was a question¬ able slight left-sided facial weakness (emotional) and a tendency to irritability, mental dulness and euphoria. Examination of the eyes showed slight haziness of the nasal margin of the left disk. Examination of the ears showed normal drums and normal hearing in both ears.
