What is a Brain Abscess? Symptoms and Treatment

Brain Abscess Symptoms

Severe headache that affects a certain part of the head and is not relieved by painkillers, changes in consciousness (confusion), muscle weakness, slurred speech, high fever, weakness, feeling and looking sick, neck stiffness (stiffness in the neck), vision-related complaints ( blurred vision, double vision), seizures, nausea and vomiting. Symptoms may progress slowly or rapidly.

Why Does It Happen?

If the immune system cannot kill and destroy foreign organisms that enter the body, it tries to surround it and prevent it from reaching healthy tissues. This is why abscess occurs.

Brain infections are rare because many protective mechanisms exist for this vital organ. It is both located in a safe box surrounded by the skull, that is, away from the external environment, and is separated from the rest of the body by the “blood-brain barrier”, which controls the passage from blood vessels to the brain. However, sometimes these defense mechanisms fail and a brain infection develops.

Brain abscess develops mainly due to 3 reasons. An inflammation in a different part of the head, such as an ear infection, sinusitis or tooth abscess, can spread to the brain through the neighborhood. About half of all brain abscesses happen for these reasons.

Second, infections in distant parts of the body (eg pneumonia) can spread to the brain via the bloodstream. People with weakened immune systems are at risk for this type of spread. People who have undergone HIV infection, chemotherapy, organ transplantation have weakened immunity. The incidence of brain abscess is also increased in people with cyanotic heart disease, where the heart cannot pump enough oxygenated blood to the body.

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Another form of occurrence is when bacteria or fungi reach the brain through a crack in the skull as a result of severe head injury. In some people, the cause of a brain abscess may not be determined.

Diagnosis

If a brain abscess is suspected with symptoms and physical examination findings, tests are performed for this. Particular attention should be paid to people who have recently had an infection and whose immune system has been weakened for any reason. Values ​​associated with infection increase in blood tests. Abscess can be visualized with brain tomography and MRI. When an abscess is detected, the abscess can be reached with a needle under the guidance of tomography, and a sample can be taken for testing and its contents can be emptied.

Treatment

A brain abscess is a medical emergency. The mass effect and edema caused by the abscess can prevent the brain from getting enough blood and oxygen. There is also a risk of the abscess bursting (rupturing). So if the abscess is left untreated, it can lead to permanent brain damage or death.

Antibiotics or antifungal drugs are given according to the microorganism causing the abscess. Antibiotics are usually given intravenously (IV). If there is an abscess and a focus where it spreads (for example, lung infection), its treatment is aimed. The abscess may need to be drained with a needle by making a hole in the skull (aspiration) or surgically removed by opening a larger part of the skull bone ( craniotomy ).

Surgery may not be recommended if there are multiple abscesses or a single abscess smaller than 2 cm, an abscess deep in the brain, if meningitis is added to the picture, if there is increased fluid in the brain (hydrocephalus). An abscess larger than 2 cm usually requires surgery.

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Complications

Brain abscesses can result in death at a rate of 5-32%. A variety of complications may develop in survivors.

Treated abscesses are likely to recur. This risk is higher in people with weakened immune systems.

An abscess can cause brain damage. Mild symptoms often improve over time, but severe brain damage can lead to permanent functional limitation and/or personality change. The risk of permanent damage increases if diagnosis and treatment are delayed. Physical therapy and rehabilitation may be required for people with brain damage .

Changes in the brain caused by the abscess can trigger the occurrence of epilepsy (seizure).

The development of meningitis, which means inflammation of the membranes surrounding the brain, is another complication.

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