International Journal of Neurology International Journal of Neurology International Journal of Neurology

Brain Abscess
An abscess in the brain of an otherwise healthy person is usually caused by bacterial infection. Fungal brain abscesses tend to occur in people with weakened immune systems. The infection will cause your brain to swell from the collection of pus and dead cells that forms.
A brain abscess forms when fungi, viruses, or bacteria reach your brain through a wound in your head or an infection somewhere else in your body. According to the Children’s Hospital of Wisconsin, infections from other parts of the body account for between 20 and 50 percent of all brain abscess cases. Heart and lung infections are among the most common causes of brain abscesses. However, brain abscesses can also begin from an ear or sinus infection, or even an abscessed tooth.

What are the risk factors?
Nearly anyone can get a brain abscess, but certain groups of people are at a higher risk than others. Some diseases, disorders, and conditions that raise your risk include:
  • a compromised immune system due to HIV or AIDS
  • cancer and other chronic illnesses
  • congenital heart disease
  • major head injury or skull fracture
  • meningitis
  • immunosuppressant drugs, such as those used in chemotherapy
  • chronic sinus or middle ear infections

What are the symptoms of a brain abscess?
Symptoms usually develop slowly over several weeks, but they can also come on suddenly. Symptoms you should watch for are:
  • differences in mental processes, such as increased confusion, decreased responsiveness, and irritability
  • decreased speech
  • decreased sensation
  • decreased movement due to loss of muscle function
  • changes in vision
  • changes in personality or behavior
  • vomiting
  • fever
  • chills
  • neck stiffness, especially when it occurs with fevers and chills
  • sensitivity to light

How is a brain abscess diagnosed?
Many of these symptoms closely resemble other diseases or health problems. Talk to your doctor immediately if you develop any of the symptoms. You’ll likely need a neurological exam. This exam can reveal any increased pressure within the brain, which can occur from swelling. CT and MRI scans can also be used to diagnose a brain abscess.
In some cases, your doctor may need to perform a lumbar puncture, or spinal tap. This involves the removal of a small amount of cerebral spinal fluid to test for any problems other than an infection. A lumbar puncture will not be performed if any significant brain swelling is suspected, as it can temporarily worsen the pressure inside the head. This is to avoid the risk of brain hematoma, or a ruptured blood vessel in the brain.

What’s the treatment for a brain abscess?
A brain abscess is a serious medical situation. A stay in the hospital will be required. Pressure due to swelling in the brain can lead to permanent brain damage.
If your abscess is deep inside your brain or it’s 2.5 centimeters or less, it will probably be treated with antibiotics. Antibiotic medications will also be used to treat any underlying infections that may have been the cause of the brain abscess. Broad-spectrum antibiotics that kill a variety of different bacteria are the most commonly prescribed. You may need more than one type of antibiotic.
Surgery is often the next step if an abscess doesn’t get smaller with the use of antibiotics. It may also be the preferred treatment for abscesses greater than 2.5 centimeters wide. Surgically removing an abscess usually involves opening the skull and draining the abscess. The fluid that’s removed is normally sent to a lab to determine the cause of the infection. Knowing the cause of the infection will help your doctor find the most effective antibiotics. Surgery may also be necessary if antibiotics aren’t working, so that the organism causing the abscess can be determined to help guide the most effective treatment.

International Journal of Neurology

International Journal of Neurology

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