Definition and causes of abscess in the brain

An abscess in the brain is an encapsulated accumulation of inflammatory material (pus) in the brain. This occurs most often due to spread of inflammation from somewhere else in the body as for example inflammation of the middle ear, sinusitis or cerebrospinal meningitis (meninges inflammation). Less often seen with blood spreading from inflammation of heart valves, pneumonia or inflammation of the teeth or intestines.

An abscess in the brain may also occur after surgery in the brain or by violent blow to the head where foreign material has entered the brain through the skull. It is usually bacteria causing the disease, but in persons with weakened immune systems it might also be a mycotic infection caused by fungous.

Symptoms of abscess in the brain

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An abscess in the brain will press on the part of the brain, which lies immediately around it, which can interfere with the function of this part of the brain. A large abscess is very serious because it will interfere with the function of a large part of the brain. Patients might have more than one abscess in the brain, which can lead to multiple symptoms with several parts of the brain being affected simultaneously.

The symptoms can vary depending on where in the brain the abscess is located. Frequent symptoms are:

• Fever.
• Headache.
• Nausea and vomiting due to elevated pressure in the brain.
• Paralysis or tactile disturbances.
• Altered awareness level.
• Epileptic seizures (see Epilepsy).
• Stiffness of neck and back.

Precautions and diagnosis

If, after having had an inflammation in the body or after brain surgery, any of the above mentioned symptoms appear immediate medical attention is required. The medical examination to establish the diagnose will involve a CT or MRI scan of brain, which will show if an abscess is involved.

Treatment of brain abscess

If the abscess is small it can be treated with broad-acting antibiotics which will often be given directly into a vein, why hospitalization is typically necessary during the treatment. Efficacy of the treatment is controlled by new brain scans to see if the abscess is decreasing in size. If the abscess on the other hand is large, surgery is necessary to quickly reduce the pressure on the brain.

Outlook and complications

A brain abscess is a potentially life-threatening condition. However, with swift and effective treatment the symptoms usually disappear with complete recovery. If the abscess is discovered or treated late, irreparable damage to the brain might have happened with permanent symptoms such as tactile disturbances or partial paralysis for life as the result. If the location and origin of the underlying infection is not found and treated, there is a risk of new abscesses in the brain.

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