Question:medium
A patient presents with ear discharge. A CT scan of the brain is shown depicting a ring-enhancing lesion. What is the most likely diagnosis?
A patient presents with ear discharge. A CT scan of the brain is shown depicting a ring-enhancing lesion. What is the most likely diagnosis?
Show Hint
Ear discharge with an intracranial ring-enhancing lesion -- consider which lobe is anatomically closest to the middle ear.
Updated On: Jun 23, 2026
- Cerebellar abscess
- Temporal lobe abscess
- Extradural abscess
- Meningitis
Show Solution
The Correct Option is B
Solution and Explanation
Answer: Temporal lobe abscess
The clinical combination of ear discharge + CT brain showing a ring-enhancing lesion localised to the temporal region is diagnostic of a temporal lobe abscess complicating chronic suppurative otitis media (CSOM).
Pathophysiology:
- The middle ear is separated from the middle cranial fossa (which houses the temporal lobe) by the tegmen tympani, a thin bony plate
- Infection from the middle ear can erode through this plate and spread directly to the temporal lobe
- The organisms involved are typically mixed anaerobic bacteria
Clinical features of temporal lobe abscess:
- Preceding ear infection/discharge
- Headache, fever, vomiting
- Dysphasia (dominant hemisphere)
- Visual field defects (superior quadrantanopia)
- Personality changes
Cerebellar abscess: also a complication of CSOM but via mastoid-posterior fossa route; presents with cerebellar signs (ataxia, nystagmus, dysdiadochokinesia)
\[\boxed{\text{Temporal lobe abscess}}\]
The clinical combination of ear discharge + CT brain showing a ring-enhancing lesion localised to the temporal region is diagnostic of a temporal lobe abscess complicating chronic suppurative otitis media (CSOM).
Pathophysiology:
- The middle ear is separated from the middle cranial fossa (which houses the temporal lobe) by the tegmen tympani, a thin bony plate
- Infection from the middle ear can erode through this plate and spread directly to the temporal lobe
- The organisms involved are typically mixed anaerobic bacteria
Clinical features of temporal lobe abscess:
- Preceding ear infection/discharge
- Headache, fever, vomiting
- Dysphasia (dominant hemisphere)
- Visual field defects (superior quadrantanopia)
- Personality changes
Cerebellar abscess: also a complication of CSOM but via mastoid-posterior fossa route; presents with cerebellar signs (ataxia, nystagmus, dysdiadochokinesia)
\[\boxed{\text{Temporal lobe abscess}}\]
Was this answer helpful?
0
