Abscess (cerebellar)

An abscess within the cerebellum usually arises from a local infective source such as chronic otitis media or mastoiditis. In this case, there is likely to be a single abscess in the subcortical white matter, whereas for rarer haematogenous spread, multiple abscess occur. There are several infecting agents if there is an otogenic aetiology.

The presentation can consist of:

• suboccipital, pounding headache
• neck stiffness
• nausea and vomiting
• signs of cerebellar dysfunction, e.g. nystagmus, hypotonia, inco-ordination, dysdiadochokinesis
• signs of mass effects: VI and VII cranial nerve palsies