Periapical odontogenic abscess as incidental finding on trauma brain CT
Severe dementia, sustained an unwitnessed fall. Right sided facial swelling. Focally inflamed area around the right lower lip, clinically suspicious for abscess. IC bleeding? Fracture?
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Significant brain atrophy and resultant ex vacuo ventriculomegaly, and diffuse, confluous deep white matter hypodensity pathognomonic for advanced small vessel ischemic changes (Fazekas III).
A few deeply hypodense foci in the basal ganglia, the largest one situated in the right thalamus measuring about 7 mm likely representing dilated perivascular spaces.
The single remaining FDI 42 tooth has a dental crown, and is surrounded by a periapical lytic area as well as significant adjacent soft tissue stranding, and irregular fluid density, indicative of odontogenic abscess that has fistulized outside the mandibula.
Periapical odontogenic abscess unrelated to acute head trauma.