Brain Abscess

A brain abscess or cerebral abscess is a collection of pus in the brain due to infection . Brain abscesses are often caused by bacterial or fungal infections in the brain triggered by head injury, or infections in other areas of the body that spread to the brain.

Brain abscess is often characterized by the emergence of severe headaches, fever, seizures, and even impaired consciousness. This condition is dangerous because it can cause brain swelling so it requires fast and proper treatment.

Causes of Brain Abscess

The main cause of a brain abscess is a bacterial or fungal infection in the brain tissue. The infection can come from an infection in the brain, a head injury, a surgical procedure on the brain, or the spread of infection from another organ.

The types of bacteria that most often cause pus buildup in the brain come from  the Bacteriodes, Streptococcus, Staphylococcus, or Enterobacter groups. While other types of pathogens that most often cause brain abscesses are the fungus Aspergillus  or the parasite Toxoplasma gondii .

There are several factors that can increase the risk of developing a brain abscess, namely:

• Having a weak immune system, for example due to suffering from HIV/AIDS, cancer, or using immunosuppressant drugs 
• Having a middle ear infection (otitis media), infection of the ear bone (mastoiditis), sinusitis, tooth infection that has formed an abscess, or meningitis
• Have a head injury, skull fracture, or have had surgery on the head or neck
• Suffering from lung infections, endocarditis, infections in the abdominal cavity, pelvic infections, or skin infections
• Suffering from congenital heart disease (CHD) or abnormalities in the pulmonary blood vessels or pulmonary arteriovenous fistula

Symptoms of Brain Abscess

Symptoms of a brain abscess can vary, depending on the size and location of the abscess. Symptoms can develop slowly or quickly.

Here are some symptoms of a brain abscess:

•  Persistent headache
• Neck or back feels stiff
• Nausea and vomiting
• High fever
• Shivering
• Seizures
• Nerve dysfunction, such as muscle weakness, paralysis, or slurred speech
• Changes in behavior, such as restlessness or confusion
• Visual disturbances, such as double, blurred, or hazy vision

When to see a doctor

See a doctor immediately  if you experience the symptoms mentioned above, especially if the severe headache is accompanied by high fever, seizures, muscle paralysis, and difficulty speaking. Brain abscesses must be treated quickly and appropriately to prevent life-threatening complications.

If you suffer from a disease that can increase the risk of developing a brain abscess, such as sinusitis, meningitis, otitis media, or heart infection, follow the treatment given by your doctor until it is complete.

Brain Abscess Diagnosis

To diagnose a brain abscess, the doctor will ask questions about the patient’s symptoms, as well as their medical and health history. Next, the doctor will perform a thorough physical examination, including a neurological examination .

The doctor will also perform supporting examinations to confirm the diagnosis and determine the cause of the brain abscess. Some of the examinations that will be performed are:

• Blood tests, to detect signs of infection from the levels and number of blood cells.
• Scans with X-rays, CT scans, or  MRIs, to determine the location and size of the brain abscess.
• Biopsy, to identify changes in cells and tissue in the brain, and to determine the pathogen causing the brain abscess.
• Lumbar puncture, to identify pathogens, including the type of bacteria that causes a brain abscess.
• Blood culture, to find out what bacteria or fungus is causing the brain abscess.
• Record brain waves or electroencephalogram (EEG), to determine electrical activity in the brain, especially in brain abscess patients who experience repeated seizures.

If a brain abscess is suspected to be caused by an infection in another part of the body, such as the respiratory tract, a sputum culture may be performed to determine the type of germ that is infecting the lungs.

Brain Abscess Treatment

Brain abscesses need to be treated immediately. The method of treatment depends on the size, number, and type of bacteria or germs that cause the abscess in the brain.

Brain abscess treatment also aims to relieve symptoms and prevent complications. Some treatment methods that doctors can do are:

Drugs

Medications are given to treat infections and reduce complaints experienced by patients. Some types of drugs that can be given are:

• Antibiotics or antifungals, to treat infections, including brain abscesses caused by toxoplasmosis
• Diuretics and corticosteroids, to reduce pressure and swelling in the brain.
• Anticonvulsant drugs, to treat seizures that can occur with a brain abscess

Operation

Surgery will be performed if the abscess is larger than 2 cm or if the abscess is at risk of rupturing and damaging the surrounding brain tissue. The purpose of surgery is to remove the abscess.

There are two types of surgery that can be performed to treat a brain abscess, namely:

Simple aspiration

Simple aspiration aims to remove accumulated pus. This action can be done with the help of a CT scan to confirm the point of the abscess.

Craniotomy

In a craniotomy, the doctor will remove a small portion of the skull bone (flap) to gain access to the infected brain tissue, then remove the abscess from the brain tissue.

After surgery, the patient must be hospitalized for some time so that his condition can continue to be monitored.

Complications of Brain Abscess

A brain abscess has the potential to cause a number of the following complications:

• Abscess recurrence
• Brain tissue damage
• Epilepsy
• Meningitis
• Sinusitis
• Infection of the bone behind the ear (mastoiditis)
• Brain swelling
• Sepsis
• Come
• Death

Brain Abscess Prevention

The way to prevent brain abscess is to avoid the causes. Some ways that can be done are:

• Undergo examination and treatment until complete if you suffer from an infectious disease.
• Maintaining dental and oral health and cleanliness, including regular check-ups with the dentist
• Use protective equipment, such as a helmet, when working in an environment that poses a risk of head injury.
• Implementing healthy sexual behavior to avoid transmission of HIV/AIDS
• Living a healthy lifestyle, such as quitting smoking, eating healthy and balanced nutritious food, and exercising regularly.
• Do not take medication carelessly
• Get vaccinated to prevent certain bacterial infections, such as meningitis, pneumonia, and Hib.

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