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Brain Abscess - Causes, Symptoms, Diagnosis, and Treatment

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Brain abscess is a severe condition characterized by the accumulation of pus in the brain. Read this article to know more.

Written by

Dr. Prerana G

Medically reviewed by

Dr. Abhishek Juneja

Published At November 4, 2022
Reviewed AtMarch 17, 2023

Introduction:

The brain is the master organ in the human body that controls many vital functions. It is a complex organ and weighs about three pounds in a healthy adult. The activity of the brain depends on messages from chemicals known as neurotransmitters. Diseases of the brain are generally life-threatening and require immediate medical attention. These conditions can range from epilepsy, brain infection, tumors, vascular disorders, stroke, mental disorders, Alzheimer's, etc.

What Is a Brain Abscess?

Brain abscess is a severe condition characterized by the formation of pus-filled swelling in the brain. It is potentially a life-threatening condition that occurs due to bacterial or fungal infection. An abscess causes swelling in the brain and might restrict the blood flow to the affected site. Additionally, brain abscesses might also put harmful pressure on the tissues.

The infections tend to occur in people with weak immune systems. The entry of bacteria or fungi can happen through a brain injury or injury somewhere in the body. It seems that microbes can also spread from ear, sinus, or tooth infections.

What Causes Brain Abscess?

The bacteria which cause brain abscesses belong to the anaerobic or mixed variety. For example, Streptococci and Staphylococci are involved in the infection after a head injury, neurosurgery, and endocarditis. Aspergillus and Toxoplasma gondii can cause brain abscesses in HIV (human immunodeficiency virus) patients.

The spread of infection can occur through:

1. Extension of infections in the skull (sinusitis, osteomyelitis, mastoiditis, etc.).

2. Wounds that penetrate deep into the head.

3. Microbes entering the bloodstream (bacterial endocarditis and congenital heart diseases).

4. Miscellaneous and unknown causes.

What Are the Signs and Symptoms of Brain Abscesses?

The symptoms of brain abscess develop several weeks after the infection.

The most common symptoms in adults include:

1. Mental disorientation, confusion, and decreased responses.

2. Decreased ability to speak or sense.

3. Personality and behavior changes.

4. Disturbances in the vision.

5. Nausea and vomiting.

6. Fever, chills, and weakness.

7. Photosensitivity (sensitivity to light).

8. Stiffness in the neck.

9. Headaches.

10. Seizures.

What Are the Symptoms in Babies and Young Children?

The symptoms are similar to that in adults; however, children may show other symptoms, such as soft spots on the head.

Other symptoms include:

1. Vomiting in a projectile way.

2. Crying with a high-pitched voice.

3. Stiffness in the limbs.

How Is a Brain Abscess Diagnosed?

Brain abscess is diagnosed based on clinical findings, patient history, laboratory, and imaging tests.

1. Medical History: The doctor will enquire regarding the recent history of infection, weak immune system, and other relevant questions related to the condition.

2. Blood Tests: A complete blood count helps check the levels of white blood cells, which increase in number during an infection.

3. Imaging Modalities: Scans such as CT (computed tomography) scan and MRI (magnetic resonance imaging) will determine the lesion's location, dimensions, and extent.

4. CT-Guided Aspiration: It is a type of biopsy where a needle is inserted into the abscess, and a sample of the pus is collected. This sample is then analyzed for specific microbes and other contents.

What Is the Treatment for Brain Abscesses?

A brain abscess should be treated immediately after the diagnosis. If not intervened early, it can lead to life-threatening complications. The choice and prognosis of the treatment depend on the following:

1. Size of the lesion (a conservative approach can treat smaller abscesses).

2. Number of abscesses present.

3. Infectious agents (viruses, bacteria, and fungi) of the abscess.

4. General and systemic health of the patient.

What Are the Treatment Options?

1. Medications: If the abscess is small, an intravenous antibiotic, antifungal, or antiviral drug would be sufficient. The smaller abscess might have to be drained before treating it with specific medication. The primary source of infection in the sinus, ears, or lungs should be addressed first.

2. Surgery: The abscess is drained and then removed carefully. This method might not be effective when there are multiple abscesses present. Surgery is recommended in the following circumstances;

  • Increasing pressure in the skull.

  • When the severity of the abscess does not resolve even after medication.

  • Presence of gaseous content in the abscess.

  • Risk of rupture of the abscess.

What Is the Procedure?

Surgeons perform a craniotomy, where an opening is made in the skull to access the lesion.

The steps of a craniotomy are:

  1. First, a small area of the scalp is shaved.

  2. A small piece of the skull bone is drilled to access the lesion.

  3. The abscess is either drained with a CT-guided needle or surgically removed.

  4. The bone is replaced with an artificial material, and the scalp is stitched.

  5. After the surgery, a short course of high-dosage corticosteroids may help relieve intracranial pressure and prevent complications.

  6. The doctor might also prescribe anticonvulsant medications to prevent seizures.

What Are the Complications Associated With Brain Abscesses?

The most common complications associated with brain abscesses are:

1. Reinfection and Recurrent Abscess - If the symptom seems to appear again and if there is a small chance of recurrence, inform your physician immediately. Recurrence is common in people with a compromised immune system.

2. Brain Damage - The abscess can cause permanent or temporary brain damage, especially if the diagnosis and treatment are delayed.

3. Epilepsy - The patient might experience repeated seizures or fits.

4. Meningitis - Infection of the meninges (protective layers of the brain) that requires immediate treatment.

Conclusion:

Brain abscess is a severe condition characterized by the accumulation of pus-filled swelling in the brain. It is potentially a life-threatening condition that occurs due to bacterial or fungal infection. The symptoms of a brain abscess include headaches, behavioral changes, vomiting, seizures, fever, chills, etc. Therefore, early diagnosis and treatment are extremely important, as untreated brain abscesses can cause life-threatening complications. The treatment involves antibiotic therapy and surgery. Advances in the imaging modality have made diagnosis and treatment easy and approachable, thereby reducing mortality and morbidity.

Frequently Asked Questions

1.

How Many Stages Are There in a Brain Abscess?

A common development of a brain abscess includes stages of inflammation, infection, cerebritis (inflammation of the brain tissue), and eventually, the creation of a covering to confine the infection. It can turn into a complete infection inside the brain if untreated.

2.

Can You Treat a Brain Abscess?

Medicinal and surgical care is necessary to treat a brain abscess. Imaging is used to make the diagnosis. Antibiotic therapy is then prescribed to cure the infection, and surgical drainage can be utilized to eliminate the abscess and release the tension in the brain. To prevent significant problems, prompt intervention is essential. For specific advice and care, please speak with a physician the professional.

3.

Who is susceptible to brain abscesses?

Brain abscesses are more common in people who have weakened immune systems, have a history of head injuries or infections, or are involved in high-risk habits like intravenous drug use. Additionally, people who have underlying illnesses like heart abnormalities or persistent sinusitis may also be at a higher risk. It's important to get evaluated and treated to avoid serious problems.

4.

What Is a Brain Abscess’ Typical Location?

The cerebral hemisphere, the region of the brain that is the largest, is where a brain abscess often develops. But it can also happen in other places, such as the brainstem or cerebellum. The precise location can change based on the infection's source and specific conditions.

5.

How Is an Abscess Determined to Be?

The combination of medical investigation, imagery (which can include ultrasonic or CT scans), and examination of pus or fluid gathered from the area of concern is usually used to determine the presence of an abscess. Localized discomfort, swelling, redness, and fever are typical symptoms. Medical practitioners use these techniques to establish the existence of an abscess and determine its size and toxicity.

6.

Do Brain Abscesses Appear on an MRI?

Because of their distinctive features, brain abscesses frequently show up as aberrant indicating areas on MRI images, which helps with diagnosis and evaluation.

7.

What Type of Bacteria Causes Brain Abscesses?

Bacteria are most frequently responsible for brain abscesses, with Streptococcus and various Staphylococcus being the main offenders. Gram-negative bacteria and anaerobic bacteria are other potential pathogens. Depending on the patient's current age, immune condition, and origin, several bacteria may be to blame for a given infection.

8.

Brain Abscesses—Can They Recover Without Surgery?

Surgery is frequently necessary to treat brain abscesses since they can be severe. On the other hand, smaller abscesses might react to antibiotics properly if found early. Nevertheless, surgery is still a regular and necessary method for efficiently draining and treating brain abscesses.

9.

How Long Does a Brain Abscess Require Medical Attention?

A brain abscess necessitates urgent medical intervention. Delaying treatment can have serious neurological side effects or possibly be dangerous. Quick diagnosis and treatment are essential for the best outcome.

10.

What Percentage of Brain Abscesses Survive?

The patient's general health, the extent and position of the brain abscess, and the speed of the treatment are only a few of the variables that can affect the patient's chance of survival. The long-term survival probability for brain abscesses is typically between 80 and 90% when treated promptly and appropriately. However, inadequate or delayed therapy may decrease the likelihood of survival.

11.

How Can Brain Abscesses Be Prevented?

Brain abscesses can be avoided by getting medical assistance for head traumas, rapidly treating infections, especially those that affect the head and face, maintaining a healthy mouth, and practicing good oral hygiene. Managing immune system-depressing illnesses, such as diabetes or HIV, can also lower the risk of developing brain abscesses.

12.

Can a Brain Abscess Be Located Using a CT Scan?

Yes, a brain abscess can be identified using a CT scan. It offers thorough cross-sectional photographs of the brain that enable medical professionals to visualize and identify the abscess's location for precise diagnosis and treatment formulation.

13.

Can a Brain Abscess Develop Cancer?

No, a cerebral abscess doesn't turn into cancer on its own. The difference between cancer and an intracranial abscess is that the unchecked proliferation of aberrant cells causes the latter. These are separate medical illnesses with unique symptoms and causes.

14.

Can a Stroke Occur From an Abscess?

Yes, a stroke can develop as a side effect of an abscess. Untreated abscesses can infect surrounding blood arteries or tissues, resulting in obstructions that could result in a stroke or the production of clots. Abscesses must be treated as a way to reduce these potential risks.

15.

What Blood Test Will Identify a Brain Abscess?

A blood culture can find the precise microorganisms causing the brain abscess, while a complete blood count, or CBC, can assist in finding indications of infection or inflammation. However, imaging tests like an MRI or CT scan that show an infection in the brain's tissue can be used to detect a brain abscess.

16.

Is a Brain Abscess a Stroke Complication?

No, a brain abscess is not a stroke implications. A stroke is often brought on by an interruption in the blood supply to the brain, whereas a brain abscess is an infection that occurs in the brain. These are separate medical illnesses with unique symptoms and causes.

17.

How Many Days Does It Take To Recover After an Abscess Surgery?

Several factors including the extent and position of an abscess and personal characteristics. The recovery period following an abscess surgery often lasts a few days to a few weeks. Most people can return to their regular activities in a week. However, full recovery can take longer. For a speedy recovery, it's essential to adhere to your doctor's post-operative instructions.

18.

When Does an Abscess Recover?

Depending on the size and location of the abscess, the healing process might take anywhere from a few days to a few weeks. Treatment from a medical professional as soon as possible, involving draining and antibiotics if required, can hasten the healing process. You must adhere to the doctor's instructions to make a full and successful recovery.
Dr. Abhishek Juneja
Dr. Abhishek Juneja

Neurology

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abscessbrain disorders
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