Cerebral and Intra-ventricular Abscess Caused by Bisphosphonate-related Osteonecrosis of the Jaw (BRONJ)

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is one of the major complications caused by prolonged bisphosphonate administration. We treated a case of BRONJ-related cerebral and intraventricular abscess. An 80-year-old woman was referred to our hospital for osteonecrosis of the maxilla. Removal of a decayed tooth followed by several oral antimicrobial administrations was performed, but the inflammation spread gradually into the orbit. Twenty-seven months after the initial treatment, she was referred to our hospital. A computed tomography (CT) scan revealed formation of an intraventricular abscess secondary to destruction of the maxillary and sphenoid sinuses. Reports of BRONJ associated with intracranial infection are rare. With prolonged life expectancy, BRONJ cases will increase with many comorbid diseases. Co-operation among physicians, dentists, and pharmacologists will be needed to treat these conditions appropriately.