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
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]
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.