title: Brain Abscess Potentially Resulting from Odontogenic Focus: Report of Three Cases and a Literature Review.
abstract: BACKGROUND
  Odontogenic foci can rarely cause intracranial infection. Hematogenous spread is considered to be the most important pathophysiological mechanism of intracranial infection of odontogenic origin. To investigate the oral origin of intracranial infections, oral surgeons should understand the underlying mechanisms by which oral bacteria spread to the central nervous system. However, there have been very few reports of intracranial infection resulting from odontogenic infection.
  
  
  METHODS
  The authors report the cases of a 64-year-old man, a 68-year-old man, and a 64-year-old woman whose brain abscesses perhaps have arisen from odontogenic foci, because other sources of intracranial infection such as endocarditis and maxillary sinusitis were not found. Bacteriological examination of brain abscess specimens identifiedStaphylococcus aureusin case 1,Streptococcus constellatus,Fusobacterium nucleatum, andParvimonas micrain case 2, andLactobacillus catenaformis,Porphyromonas gingivalis, andF. nucleatumin case 3. All suspected causal teeth had no obvious signs of acute inflammation in all three cases.
  
  
  CONCLUSIONS
  Oral surgeons should understand these characteristics of odontogenic brain abscess, in which the potentially causal odontogenic foci often lack acute symptoms. If other origins of infection are not found, it would be better to eliminate the potentially causal odontogenic foci for improvement of oral hygiene, however, the decision making criteria to eliminate suspected causal teeth is needed to be elucidated.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kusumoto
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Shungo
authors.initials: S
authors.lastname: Furudoi
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Kohkichi
authors.initials: K
authors.lastname: Hosoda
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
keywords: Brain abscess; Drainage; Magnetic resonance image; Odontogenic foci