Brain Abscess Flashcards
Causes of a brain abscess?
may result form a number of causes including:
- extension of sepsis from middle ear or sinuses
- trauma
- surgery to the scalp
- penetrating head injuries
- embolic events from endocarditis
The presenting symptoms will depend upon?
the site of the abscess (those in critical area eg motor cortex) will present earlier
Abscesses have a considerable mass effect in the brain and raised ICP is common
What are the main presenting symptoms?
Headache : often dull, persistent
Fever : may be absent and usually not the swinging pyrexia seen with abscesses at other sites
Focal neurology : eg oculomotor nerve palsy or abducens nerve palsy secondary to raised ICP
Other features consistent with raised ICP:
- nausea
- papilloedema
- seizures
Investigations of brain abscesses?
CT and MRI scanning
What might an MRI scan show with brain abscess?
A ring-enhancing lesion in the right frontal lobe with surrounding oedema
Management of brain abscess?
Surgery
- 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 eg dexamethasone
