brain abscess

Question 1

what is a brain abscess?

Answer 1

A brain abscess is a collection of pus within the brain parenchyma. It is a very serious condition which can lead to significant morbidity and mortality, especially if left untreated.

Question 2

Rf for Brian abscess?

Answer 2

Sinusitis
Dental, head & neck procedures
Cardiac defects & endocarditis
Poor immune response including HIV, immunocompromise

Question 3

what bacteria implicated in brain abscess?

Answer 3

Streptococcus
oral bacteria eg staph, gram -ve, TB, fungi, parasites

Question 4

features of brain abscess?

Answer 4

fever, nausea & vomiting, meningism
Raised intracranial pressure: headache, third nerve palsy, papilloedema, seizures
Focal neurology depending on location of abscess

Question 5

what ix do you do for brain abscess?

Answer 5

Bloods - including FBC, CRP, clotting, VBG, cultures
Cross-sectional imaging:
MRI - will show an enhancing lesion.
urgent CT head if stroke suspected
Neurosurgical aspiration/excision & cultures

Question 6

how do you manage brain abscess?

Answer 6

A-E, initiate sepsis 6
Neurosurgical intervention: aspiration or excision
Medical: antibiotics - initially a 3rd-generation cephalosporin + metronidazole.
Symptom management - for example anticonvulsants for seizures, dexamethasone for severely raised intracranial pressure

Question 7

complications of brain abscess?

Answer 7

Sepsis
Raised intracranial pressure & herniation
Permanent neurological deficits
Death