This paper contains a report of two cases of metastatic abscess of the brain from the neurosurgical service of the University of Pennsylvania Hospital. The sequence of events in the two cases was exactly similar and rather unusual; namely, tonsillectomy, abscess of the lung, and abscess of the brain, with recovery in the patient with solitary cerebral abscess and death in the patient with multiple abscesses.
Abscesses of the brain may arise from an adjacent area of suppuration, such as disease of the middle ear, infection of the sinuses and traumatic cranial lesions; they may be secondary to a retrograde cerebral thrombophlebitis, or they may be metastatic or hematogenous in origin. The last group is considerably smaller than the preceding two and it has been estimated (Eagleton) that about 12 per cent of the metastatic abscesses are of pulmonary origin.
Probably the largest collection of reports of abscess of the