Periapical odontogenic abscess as incidental finding on trauma brain CT

Case contributed by Dr Balint Botz

Presentation

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?

Patient Data

Age: 90 years
Gender: Female

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. 

Case Discussion

Periapical odontogenic abscess unrelated to acute head trauma. 

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Case information

rID: 83275
Published: 20th Oct 2020
Last edited: 21st Oct 2020
Inclusion in quiz mode: Included
Institution: University of Pécs