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A brain abscess is a focal encephalitis that is rare but very dangerous. The reason for its appearance is usually bacterial infections in other organs. What are the symptoms of a brain abscess and how is it treated?
Brain abscessarises when as a result of an infection most often caused by bacteria (e.g. streptococcus,Haemophilus , blue oil stick - Pseudomonas aeruginosa ,Streptococcus viridans , golden staph -Staphylococcus aureus , mushrooms ( Candida ,Cryptococcus neoformans ,Aspergillus ) or protozoa (in AIDS patients -Toxoplasma gondi) the brain becomes inflamed and breaks down, which becomes encysted in the form of fluid (pus).
Brain abscess: causes
An abscess is usually a complication of a bacterial, fungal or protozoal infection. These pathogens enter the brain either with the blood, or the inflammation they cause, such as sinusitis, destroys the bones that separate the brain from diseased tissues.
In children and infants, a brain abscess may develop in the course of cyanotic heart defects or vascular defects involving the pulmonary circulation.
It also happens that an abscess is caused by pathogens entering the brain as a result of an open craniocerebral trauma or a fracture of the skull bones. The most common diseases that can contribute to the formation of a brain abscess are:
- chronic paranasal sinusitis
- otitis media
- respiratory tract infection
- tooth decay, inflammation within the oral cavity (tooth abscess, periodontitis), dental procedures (tooth extraction or root canal treatment)
- mastoiditis
- head injuries
- postoperative infection
- sepsa
- lung abscess
- bronchiectasis
- infective endocarditis
A brain abscess is favored by reduced immunity in the course of AIDS, post-transplant immunosuppression, chemotherapy and steroid therapy.
Brain abscess: symptoms
Symptoms that cause a brain abscess can be divided into three groups: 1. symptoms caused by an increase in intracranial pressure due to the pressure of the abscess on the brain structures:
- headaches - dull and diffuse
- nausea
- vomiting
- confusion
- congestive disc - swelling of the optic nerve disc is one of the late symptoms of a brain abscess
2. symptoms caused by infection
- fever
- fatigue
3. symptoms resulting from brain damage - their type depends on where the abscess is located:
- hemiparesis
- sensory disturbance
- speech disorder
- epileptic seizures
It should be remembered that if there is no meningitis at the same time, the first symptom may not be a fever, but a neurological disorder, e.g. an epileptic seizure.
Brain abscess: diagnosis
When making the diagnosis, the information obtained in the medical history and the results of computed tomography are taken into account - after 4-5 days of inflammation, the abscess gives an image of the ring surrounding the darker area. The blood test shows elevated levels of white blood cells and C-reactive protein (CRP) and a high Biernacki test (ESR).
Examination of the cerebrospinal fluid does not reveal changes typical for a brain abscess, and the collection of cerebrospinal fluid (spinal puncture) is not recommended, as lowering the intracranial pressure may lead to intussusception. Microbiological cultures of blood and fluid are usually negative - the pathogen responsible for the occurrence of changes in the brain can only be grown from material collected directly from the abscess.
Brain abscess: treatment
Treatment of an abscess consists of administering antibiotics and, in most cases, puncturing and emptying the abscess to lower the intracranial pressure.
It is extremely important to locate the primary source of infection and treat it.
If the abscess is small (less than 3 cm in diameter), only pharmacological treatment is sometimes attempted - antibiotics are administered for many weeks and the size of the abscess is monitored by imaging tests. According to specialists, this procedure is only effective when treatment was started before the formation of a thick abscess capsule, the duration of symptoms was less than 2 weeks, and when symptom relief is evident within 7 days of starting treatment. If these conditions are not met, surgery is required. During the operation, if it is not possible to remove the abscess completely, only the liquid contents are aspirated, leaving the sachet in order not to spread the infection. Performing a bacteriological examination of the abscess content allows for a more precise selectionmedications.