Brain abscess

From WikiLectures

The cerebral abscess (abscessus cerebri) is an inflammatory process directly within the brain parenchyma.

Penetration of inflammation[edit | edit source]

Inflammation can go to the brain:

  • directly through the bone in chronic inflammation of the paranasal sinuses and middle ear
  • penetrating craniocerebral injury or post-traumatic cerebrospinal fluid
  • Brain abscess
    hematogenous transmission from a distant inflammatory deposit (chronic bronchitis, bronchiectasis and lung abscess, infectious endocarditis, in a young patient it can be HIV infection, immunodeficiency or drug abuse)

Pathogens[edit | edit source]

Brain abscess can be caused by Staphylococcus epidermidis, Staphylococcus aureus (post-traumatic abscess), mixed flora incl. anaerobes, enterobacteria.

Symptoms[edit | edit source]

Symptoms are usually non-specific, but they can also be intracranial hypertension (headaches, mental changes, disorder of consciousness) or focal neurological deficit.

Diagnostics[edit | edit source]

  • the anamnesis is important
  • CT, MRI (collagen hyperdense capsule and hypodense center with pus)

Differential diagnostics[edit | edit source]

Laboratory finding[edit | edit source]

Uncharacteristic, blood culture often negative, there may be leukocytosis in the blood count, CSF examination is abnormal in 90% of cases, but uncharacteristic.

Therapy[edit | edit source]

Microbiological examination of the puncture and subsequent targeting of ATB treatment is important, samples are sent for examination for aerobic and anaerobic cultures, fungal and TB (tuberculosis) examinations.

Surgical treatment

Puncture of the abscess and suction of its contents. In the case of a large abscess on the surface of the brain, open resection (including capsule)

  • The capsule is a barrier preventing the achievement of effective ATB concentrations within the abscess → ATB treatment
ATB treatment

Long-term, 2–4 months, with the intravenous phase lasting 6 weeks, the effect of treatment is checked by repeated CT examinations.

Lethality[edit | edit source]

Today, the lethality is around 10%. Neurological deficit or epilepsy persists in 30% of patients after successful treatment.

Links[edit | edit source]

Related articles:[edit | edit source]

References:[edit | edit source]

  • SAMEŠ, M, et al. Neurochirurgie. 1. vydání. Praha : Jessenius Maxdorf, 2005. ISBN 80-7345-072-0.