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Brain Abscess

Overview

An abscess in the brain of an otherwise healthy person is usually caused by bacterial infection. Fungal brain abscesses tend to occur in people with weakened immune systems. The infection will cause your brain to swell from the collection of pus and dead cells that forms.

A brain abscess forms when fungi, viruses, or bacteria reach your brain through a wound in your head or an infection somewhere else in your 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. Heart and lung infections are among the most common causes of brain abscesses. However, brain abscesses can also begin from an ear or sinus infection, or even an abscessed tooth.

See your doctor right away if you think you may have a brain abscess. You’ll need the appropriate treatment to prevent any brain damage from the swelling.

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Risk factors

What are the risk factors?

Nearly anyone can get a brain abscess, but certain groups of people are at a higher risk than others. Some diseases, disorders, and conditions that raise your risk include:

Certain birth defects allow infections to reach the brain more easily through the teeth and intestines. One example of this is tetralogy of Fallot, which is a heart defect.

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Symptoms

What are the symptoms of a brain abscess?

Symptoms usually develop slowly over several weeks, but they can also come on suddenly. Symptoms you should watch for are:

  • differences in mental processes, such as increased confusion, decreased responsiveness, and irritability
  • decreased speech
  • decreased sensation
  • decreased movement due to loss of muscle function
  • changes in vision
  • changes in personality or behavior
  • vomiting
  • fever
  • chills
  • neck stiffness, especially when it occurs with fevers and chills
  • sensitivity to light

In babies and young children, most of the symptoms are similar. However, your child may show other symptoms of a brain abscess. The soft spot on top of your baby’s head, called the fontanelle, may be swollen or bulging. Other symptoms in your child can include:

  • projectile vomiting
  • high-pitched crying
  • spasticity in the limbs
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Diagnosis

How is a brain abscess diagnosed?

Many of these symptoms closely resemble other diseases or health problems. Talk to your doctor immediately if you develop any of the symptoms. You’ll likely need a neurological exam. This exam can reveal any increased pressure within the brain, which can occur from swelling. CT and MRI scans can also be used to diagnose a brain abscess.

In some cases, your doctor may need to perform a lumbar puncture, or spinal tap. This involves the removal of a small amount of cerebral spinal fluid to test for any problems other than an infection. A lumbar puncture will not be performed if any significant brain swelling is suspected, as it can temporarily worsen the pressure inside the head. This is to avoid the risk of brain hematoma, or a ruptured blood vessel in the brain.

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Treatment

What’s the treatment for a brain abscess?

A brain abscess is a serious medical situation. A stay in the hospital will be required. Pressure due to swelling in the brain can lead to permanent brain damage.

If your abscess is deep inside your brain or it’s 2.5 centimeters or less, it will probably be treated with antibiotics. Antibiotic medications will also be used to treat any underlying infections that may have been the cause of the brain abscess. Broad-spectrum antibiotics that kill a variety of different bacteria are the most commonly prescribed. You may need more than one type of antibiotic.

Surgery is often the next step if an abscess doesn’t get smaller with the use of antibiotics. It may also be the preferred treatment for abscesses greater than 2.5 centimeters wide. Surgically removing an abscess usually involves opening the skull and draining the abscess. The fluid that’s removed is normally sent to a lab to determine the cause of the infection. Knowing the cause of the infection will help your doctor find the most effective antibiotics. Surgery may also be necessary if antibiotics aren’t working, so that the organism causing the abscess can be determined to help guide the most effective treatment.

Surgery must be performed in the most severe cases when the abscess causes a dangerous buildup of pressure in the brain. Your doctor may recommend surgery as the best option in the following cases:

  • Your brain abscess is at risk of rupturing inside of your skull.
  • Your brain abscess contains gasses sometimes produced by bacteria.
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Prevention

Can a brain abscess be prevented?

A brain abscess is a serious medical condition. Prevention is important. You can lower your risk by monitoring any conditions that can cause a brain abscess. Call your doctor at the first sign of a brain abscess.

If you have any type of heart disorder, talk with your doctor before having any dental or urological procedures. Your doctor can prescribe antibiotics for you to take before these procedures. This will reduce your risk of an infection that could spread to your brain.

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