Brain abscess Epidural abscess, cerebral abscess

Basic Information

What is Brain abscess?

A collection of pus caused by a bacterial infection in the brain or the outermost of three membranes that cover the brain and spinal cord.

Brain abscess signs and symptoms

The following symptoms usually appear gradually over several hours. They resemble symptoms of a brain tumor or stroke:

• Pain in the back, if the infection is in the covering of the spinal cord.
• Headache.
• Nausea and vomiting.
• Weakness, numbness or paralysis of one side of the body.
• Irregular gait.
• Convulsions.
• Fever.
• Confusion or delirium.
• Speaking difficulty.

Causes

The primary source of bacterial infection that causes a brain or epidural abscess often cannot be found. These three sources are the most common:

• An infection that spreads from an infected skull, such as in osteomyelitis, mastoiditis or sinusitis.
• An infection that is introduced by a skull injury.
• An infection that spreads through the bloodstream from other infected organs, such as the lungs, skin or heart valves.

Risk increases with

• Head injury.
• Illness that has lowered resistance, especially diabetes mellitus.
• Recent infection, especially around the nose, eyes and face.
• Immunosuppressed patient due to illness (AIDS) or medications.
• Intravenous drug abuse.

Preventive measures

• Seek medical advice for any infection in your body, especially one around the nose or face, to prevent its spread (such as ear infection or dental abscess).
• Wear protective headgear when engaging in any activity where risk of head injury is possible.

Expected outcomes

Usually curable with early diagnosis and treatment.

Possible complications

• Seizures, coma and death without treatment.
• Permanent brain damage.

Brain abscess treatment

General measures

• Diagnostic tests may include laboratory studies such as blood studies, spinal-fluid studies; other tests such as EEG, computed tomography (CT scan), X-rays of the skull.
• Intensive care monitoring required.
• Medical or surgical treatment will depend on location of abscess. Normally requires antibiotic therapy and surgery to drain the abscess. Other treatment may include intravenous fluids and mechanical breathing support.
• Additional information available from the Brain Research Foundation.

Medications

• Antibiotics for 4 to 6 weeks to fight infection.
• Anticonvulsants to prevent seizures.
• Following surgery, corticosteroids to reduce swelling (edema).

Activity

While in the hospital, you will need bed rest. After a 2 to 3 week recovery you should be as active as your strength and feeling of well-being allow.

Diet

Intravenous fluids and feedings are usually necessary during hospitalization because of swallowing difficulty. After treatment, no special diet is necessary.

Last updated 10 May 2016