An abscess of the brain is usually the result of a bacterial or fungal infection. The infection will cause your brain to swell from the collection of pus and dead cells that form.
A brain abscess can form when fungi, viruses, or bacteria reach the brain through a wound to the head or infection elsewhere in the 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. (CHW) Both heart and lung infections are among the most common causes of brain abscesses, but brain infections can also begin as an ear infection or even an abscessed tooth.
A brain abscess requires immediate emergency attention to prevent any brain damage from the swelling.
Nearly anyone can get a brain abscess, but there are certain groups of people at higher risk than most. 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
- immunosuppressant drugs, such as those used in chemotherapy
- chronic sinus or middle ear infections
- certain birth defects, such as tetralogy of fallot (heart defect) allow infections to reach the brain more easily from the teeth and intestines
Symptoms usually develop slowly over a period of weeks. But sometimes they seem to come on suddenly. Symptoms you should watch for are:
- differences in mental processes, such as increased confusion, decreased responsiveness, and irritability
- decreased speech and sensation
- decreased movement due to loss of muscle function
- changes in vision
- fever and chills
In babies and young children, most of the symptoms are similar. But your child may have a brain abscess if they are exhibiting any of the below symptoms:
- a bulging or swollen soft spot (fontanel) on the top of the baby’s head
- projectile vomiting
- high-pitched crying
- spasticity in the limbs
Many of these symptoms closely resemble a number of other illnesses and health problems, so consult with your doctor immediately if you should develop any of the symptoms. You will need a neurological exam, which can reveal any increased pressure in the skull. Other methods of diagnosing a brain abscess include a head CT (computed tomography) scan, blood test, and magnetic resonance imaging (MRI).
In some cases, a lumbar puncture may be performed. This involves the removal of a small amount of cerebral spinal fluid to test for any problems other than an infection. In the event there is any brain swelling, a lumbar puncture would not be performed. This is to avoid the risk of brain hematoma or a ruptured blood vessel in the brain.
A brain abscess is an emergency situation. Pressure due to swelling in the brain can cause reduced blood flow, which can cause permanent brain damage. A stay in the hospital will be required to treat the abscess.
If the abscess is located deep inside the brain or is less than 2 centimeters, antibiotics are most often prescribed for treatment. Antibiotic medications will also be used to treat any underlying infections. Broad-spectrum antibiotics that kill a variety of different bacteria are the most commonly prescribe, but in some instances more than one type of antibiotic is necessary
Surgery is performed in the most severe cases when the abscess causes a dangerous buildup of pressure in the brain. Surgery is also considered the best option in the following situations:
- abscesses that are at risk of rupturing inside of the skull
- abscesses that contain gases sometimes produced by bacteria
If an abscess does not get smaller with the use of antibiotics, surgery is often the next step. Surgery for the removal of an abscess most commonly involves opening the skull and draining the abscess. The fluid that is removed is normally sent to labs to determine the cause of the infection, and this information helps with prescribing the most effective antibiotics.
Brain abscesses are a serious medical condition, so prevention is important. You can lower your risk by monitoring any conditions that may result in a brain abscess. At the slightest sign, seek immediate medical attention. If you have any disorders of the heart, you will want to consult with your physician before having any dental or urological procedures. Antibiotics may be prescribed prior to such procedures to reduce your risk of infection that could spread to your brain.