A brain abscess is a collection of immune cells, pus, and other material in the brain, usually from a bacterial or fungal infection.
Brain abscesses commonly occur when bacteria or fungi infect part of the brain. Swelling and irritation (inflammation) develops in response. Infected brain cells, white blood cells, live and dead bacteria, and fungi collect in an area of the brain. A membrane forms around this area and creates a mass.
While this immune response can protect the brain by isolating the infection, it can also do more harm than good. The brain swells. Because the skull cannot expand, the mass may put pressure on delicate brain tissue. Infected material can block the blood vessels of the brain.
The bacteria or fungi that cause a brain abscess commonly reach the brain through the blood. The source of the infection is often not found. However, the most common source is a lung infection. Bacteria or fungi may also travel from a nearby infected area (for example, an ear infection) or be introduced into the body during an injury (such as a gun or knife wound) or surgery.
What Are The Symptoms Of A Brain Abscess?
The following are the most common symptoms of a brain abscess. However, each child may experience symptoms differently. Symptoms may include: -
- in babies and younger children:
- a full or bulging fontanelle (soft spot located on the top of the head)
- sleepiness or less alert than usual
- increased irritability
- high-pitched cry
- poor feeding
- projectile vomiting
- in older children:
- complaints of severe headaches
- nausea and vomiting
- changes in personality or behavior
- changes in speech
- problems walking
- increased movement in the arms or legs (spasticity)
The symptoms of a brain abscess may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
The following raise your risk of a brain abscess: -
- A weakened immune system
- Chronic disease, such as cancer
- Drugs that suppress the immune system
- Right-to-left heart shunts
- congenital (present at birth) heart disease
- chronic middle ear and sinus infections
- dental or jaw infections
- infections of the face or scalp
- head injury or skull fracture
- traction - a medical device that uses pins/screws that are placed around the head to hold the head and neck areas still; used in patients with broken necks or for specific surgeries that require the head and neck to be immobilized.
- shunt (devices used to drain excess amounts of cerebral spinal fluid) infections
Treatment For A Brain Abscess
Specific treatment for a brain abscess will be determined by your child's physician based on
- your child's age, overall health, and medical history
- the extent of the condition
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of condition
- your opinion or preference
The key to treating a brain abscess is early detection and treatment. A child with a brain abscess requires immediate hospitalization, surgery, and close monitoring. The goal of treatment is to reduce the pressure in the head and to properly drain the infection. Medications are used to control the infection, seizures, fever, and/or other conditions that may be present.
As the child recovers, physical, occupational, or speech therapy may be needed to help the child regain muscle strength and/or speech skills.
The healthcare team educates the family after hospitalization on how to best care for their child at home and outlines specific clinical problems that require immediate medical attention by his/her physician. A child with a brain abscess requires frequent medical evaluations following hospitalization.
How Is A Brain Abscess Diagnosed?
Diagnostic tests that may be performed to confirm the diagnosis of brain abscess may include the following: -
- blood tests
- x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. Intravenous (IV) contrast agents may be given during the scan to better highlight the abscess.
- computed tomography scan (Also called a CT or CAT scan.) -a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- urine and stool tests
- sputum culture -a diagnostic test performed on the material that is coughed up from the lungs and into the mouth. A sputum culture is often performed to determine if an infection is present.
- lumbar puncture (spinal tap) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems.
CSF is the fluid that bathes your child's brain and spinal cord. If there is significant brain swelling or shift in the brain tissue, a lumbar puncture may be deferred or not done at all (due to concerns about brain hematoma).
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