A cerebral abscess is an infection in your brain. It is a medical emergency that requires treatment right away. Symptoms can include headache, fever, changes in consciousness, confusion, neck stiffness, vomiting, seizures, weakness, trouble moving, and changes in vision.
You might also have pain when you touch the abscess and surrounding area. Some abscesses form a head. This means that you can see yellow pus on part of it (similar to a pimple). They might open on their own and drain yellow pus or bloody fluid.
A brain abscess is regarded as a medical emergency. Swelling caused by the abscess can disrupt the blood and oxygen supply to the brain. There's also a risk of the abscess bursting (rupturing). If left untreated, a brain abscess can cause permanent brain damage and could be fatal.
Most people with brain abscess will have a headache that is different from a typical headache. The headache usually gets worse with time. Neurological symptoms can also develop such as muscle weakness, paralysis on one side of the body, trouble speaking (like slurred speech), or poor coordination.
The symptoms of a brain abscess result from a combination of infection, brain tissue damage, and pressure on the brain, as the abscess grows to take up more space. If the headache suddenly becomes worse, it may mean that the abscess has burst. In two-thirds of cases, symptoms are present for as long as 2 weeks.
A headache (69% to 70%) the most common medical symptom. Mental status changes (65%) lethargy progressing to coma is indicative of severe cerebral edema and a poor prognostic sign. Focal neurologic deficits (50% to 65%) occur days to weeks after the onset of a headache.
Pathogenesis. Brain abscess development can be divided into four stages: 1) early cerebritis (1–4 days); 2) late cerebritis (4–10 days); 3) early capsule formation (11–14 days); and 4) late capsule formation (>14 days). Staging of brain abscess in humans has been based on findings obtained during CT or MRI scans.
Tests for encephalitis can include: Neuroimaging, such as a brain MRI or CT scan. A lumbar puncture (spinal tap) to check for signs of infection in the brain or spinal cord. Electroencephalogram (EEG) to look for seizures or specific patterns of electrical activity in the brain.
A brain and nervous system (neurological) exam will usually show signs of increased pressure inside the skull and problems with brain function. Tests to diagnose a brain abscess may include: Blood cultures. Chest x-ray.
Encephalitis may cause many different symptoms including confusion, personality changes, seizures or problems with movement. Encephalitis also may cause changes in sight or hearing. Most people with infectious encephalitis have flu-like symptoms, such as: Headache.
A brain abscess can grow very quickly, typically becoming fully formed within about two weeks. Your doctor will begin treatment immediately after you are diagnosed. Prompt medical attention is the key to relieving your symptoms more quickly and minimizing damage to your long-term health.
Left untreated, a brain abscess may lead to neurological damage, and ultimately death. The overall mortality rate from a brain abscess is 10 percent, but if the abscess ruptures into the ventricle (the fluid chambers in the brain), the mortality rate goes up to as much as 25 to 40 percent.
Although they are not usually life threatening, you should seek medical help if you notice an abscess on your body. If you discover a lump or unusual spot on your skin or in your mouth that is sore, red or inflamed and warm to the touch, you should see an emergency room doctor to examine the affected area.
If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell. In severe cases, you may find it hard to fully open your mouth and have difficulty swallowing or breathing.
Abscess occurs most commonly in the frontal lobe but may occur in any location. Location is closely associated with source. Otogenic abscess occurs almost exclusively in the temporal lobe and cerebellum, while abscess associated with sinus infection is predominantly frontal.
Headache is the presenting symptom; it is often dull, generalized, and in 50% of patients accompanied by fever. Signs and symptoms of elevated intracranial pressure and cerebral edema develop gradually. Focal neurologic deficits are present in 50% of patients and include paresis, paralysis, aphasia, and seizures.
People with a weakened immune system have a higher risk of developing a brain abscess from a blood-borne infection.
More than 75% of people with a brain abscess have a dull, achy headache. For many people this is the only symptom. The pain usually is limited to the side of the brain where the abscess is, and the pain usually becomes worse until the abscess is treated. Aspirin and other pain medication do not relieve the pain.
Routine tests in patients with brain abscess include the following: CBC count with differential and platelet count. Erythrocyte sedimentation rate (ESR; elevated in up to two thirds of patients) Serum C-reactive protein (CRP) or Westergren sedimentation rate.
Treat all brain abscesses with antibiotics (usually initially with ceftriaxone or cefotaxime plus metronidazole if clinicians suspect Bacteroides species or plus vancomycin if they suspect S. aureus), typically followed by CT-guided stereotactic aspiration or surgical drainage.
The CT in our second case shows low attenuation with mass effect in the right thalamus. The contrast-enhanced CT scan in the patient demonstrated rim enhancement of the mass. This finding can be seen with primary tumors, metastatic tumors, and brain abscesses.
For instance, diffusion-weighted (DWI) MRI has been suggested to differentiate brain abscess from primary, cystic, or necrotic tumors (20), based on the limited free motion of water molecules in the viscous milieu in the necrotic center of abscess cavity.
Simple aspiration involves using a CT scan to locate the abscess and then drilling a small hole known as a "burr hole" into the skull. The pus is drained and the hole sealed. A simple aspiration takes around an hour to complete.