Brain Abcess

Question 1

Brain abscesses may result from ?

Answer 1

Majority ;
extension of sepsis from middle ear or sinuses,

Or
trauma
or surgery to the scalp,
penetrating head injuries
and embolic events from endocarditis

Question 2

Features of brain abcess ?

Answer 2

headache : often dull, persistent

fever
may be absent and usually not the swinging pyrexia seen with abscesses at other sites

focal neurology:
e.g. oculomotor nerve palsy or abducens nerve palsy secondary to raised intracranial pressure
other features consistent with raised intracranial pressure
nausea
papilloedema
seizures

Question 3

Investigation of brain abcess ?

Answer 3

Ct scan ring enhancement

Question 4

Tx of brain abcess

Answer 4

a craniotomy is performed and the abscess cavity debrided
the abscess may reform because the head is closed following abscess drainage.

IV antibiotics: IV 3rd-generation cephalosporin + metronidazole
intracranial pressure management: e.g. dexamethasone