A brain abscess or brain abscess is a collection of pus in the brain. The cause is my a limited and locally fixed infection in the brain. Without antibiotic therapy, the death rate of brain abscess would be very high.
What is brain abscess?
Schematic diagram showing the anatomy and structure of the brain. Click to enlarge. A brain abscess, or brain abscess, is a local infection of the brain as a result of which a collection of pus develops that encapsulates into an abscess. When certain areas of brain tissue become inflamed, a body cavity forms in the core of the inflamed area due to a meltdown of the local tissue. The inflammation causes pus to form, which is collected in this newly formed cavity. When the collection of pus becomes encapsulated, a condition called an abscess is formed. A brain abscess occurs very rarely with a probability of 1 in 100,000. Brain abscesses most commonly occur in adults between the ages of 20 and 30. Children are most commonly affected between the ages of 4 and 7. Usually, only a single brain abscess forms in the cerebrum. Multiple abscess formations as well as abscesses in the cerebellum rarely occur. In any case, a brain abscess requires medical treatment.
Causes
Brain abscesses are caused by infections. Usually, these are infections of bacterial origin. In half of all brain abscesses caused by bacterial infections, the bacteria originate from infections of other, nearby, areas of the body. The origin of a brain abscess can therefore be diseases such as middle ear infections or sinus infections that have not been properly cured. The other half of all abscesses are often caused by infections from more distant areas of the body, when bacteria enter the brain from here via the bloodstream. Injuries to the brain from accidents or surgery can also result in brain abscesses. Fungi or other non-bacterial pathogens are also a possible cause, although only with a very low probability. However, for this to occur, other factors must be present at the same time that favor a brain abscess, such as a previously weakened immune system.
Symptoms, complaints, and signs
The symptoms of a brain abscess depend on the area of the brain where the abscess is located. In addition, the size of the abscess also plays a major role. Initially, symptoms tend to be nonspecific. Thus, headache, nausea and vomiting are some of the main complaints. These symptoms are produced by the increased pressure emanating from the abscess itself as well as from the cerebral edema. Therefore, they are also called intracranial pressure symptoms. Other symptoms depend on the location of the brain abscess. These may include disturbances of consciousness as well as so-called cerebral focal symptoms. Cerebral focal symptoms include visual disturbances, speech disorders, swallowing disorders or paralysis. Sometimes a brain abscess is also accompanied by epileptic seizures and fever. Thus, approximately 50 percent of all affected individuals suffer from fever. A brain abscess is generally a life-threatening condition. Thus, the abscess capsule can press on neighboring regions of the brain. How dangerous this pressure is depends on which bodily functions are controlled there. Furthermore, it is also possible for the inflammation to spread to other areas of the brain. A particularly life-threatening condition is when inflammation occurs in the space between the hard meninges and the periosteum of the skull. However, this is rarely the case. Overall, the mortality rate for brain abscesses has fallen to five to ten percent today. In severe cases, however, late effects such as epileptic seizures and other neurological problems are still possible even after successful treatment.
Diagnosis and course
A brain abscess develops at different rates depending on the cause and physical condition. Therefore, the incubation period can be as short as a few weeks in accidents to as long as several months or even years. A brain abscess can cause a number of different symptoms. Due to the pressure that a brain abscess exerts on the surrounding brain regions, a brain abscess is most often manifested by massive headaches, which are often also accompanied by nausea, vomiting and fever.Depending on where the brain abscess is located, it can also trigger epileptic seizures, and now and then speech, vision and movement disorders. Often, a so-called edema develops after a brain abscess due to the increased accumulation of fluid in the immediate vicinity. If a brain abscess is suspected, a laboratory blood test is usually performed first to check for possible signs that point to a brain abscess. These include elevated levels of inflammation with antibodies to the pathogens underlying the inflammation detected in the blood. If the suspicion of a brain abscess is confirmed, imaging techniques are used. Computed tomography scans or magnetic resonance imaging (MRI) scans can visualize brain abscesses and thus confirm them.
Complications
A brain abscess represents a very serious health condition in which death will occur without treatment. For this reason, a brain abscess must always be examined and treated by a physician. Due to this disease, there is a restriction of bodily functions. However, which regions and functions are affected depends on the severity of the infection. In most cases, however, those affected suffer from headaches and vomiting. Furthermore, there is nausea and not infrequently migraine attacks. Without treatment, sensory disturbances and paralysis occur, and epileptic seizures may also occur. The patient’s vision is also reduced by the brain abscess, and movement and coordination disorders occur. Likewise, the patient’s actions and thinking are impaired and there is a general lapse in comprehension. The quality of life decreases extremely and the patient is dependent on the help of other people due to the disease. Without treatment, there is a drastic reduction in life expectancy. The nervous system is irreversibly damaged. The treatment itself is carried out without complications with the help of antibiotics. With early treatment, secondary damage can be avoided.
When should you go to the doctor?
If massive headaches and nausea occur repeatedly, a brain abscess may be present. A visit to the doctor is recommended if the symptoms persist for more than a week and are not due to any specific cause. If the symptoms intensify rapidly and develop into a full-blown migraine, medical advice is required. The sudden occurrence of epileptic seizures or speech, vision and movement disorders also indicates a serious condition that needs to be clarified. A brain abscess often occurs in conjunction with a middle ear or sinus infection that has not been properly cured. Infections in other parts of the body and injuries to the brain from surgery or accidents can also cause an abscess in the brain. Anyone who belongs to these risk groups should consult a medical professional immediately with the symptoms mentioned. Pregnant women, elderly people and children with persistent headaches and nausea should always consult a doctor. In addition to the family doctor, affected people can also talk to a neurologist or a specialist in internal medicine.
Treatment and therapy
A brain abscess usually needs to be removed surgically, but in individual cases it depends on various factors such as the cause, location, size and number of the abscess or abscesses, and the patient’s condition. Brain abscesses located in the upper layers of the brain are usually removed as quickly as possible by surgical intervention. For brain abscesses in deeper and difficult-to-access areas, some preparatory measures are usually performed before surgery. Usually, abscesses are punctured through a burr hole in a first procedure, the accumulated pus is drained and the abscess cavity is flushed. The remaining capsule is then removed in a second procedure. In addition, the pathogens as well as the causative infections are treated concomitantly with the therapy in order to prevent the abscess from forming again. If surgery is impossible for various reasons or if several very small abscesses have formed, a purely antibiotic-based treatment method can also be chosen. Due to medical advances, very few brain abscesses are fatal. Most patients recover completely without permanent damage after successful removal of the abscess.In some cases, however, irreparable damage to the nervous system occurs due to the abscesses. Epilepsies are particularly common in this case. In some cases, brain abscesses also recur again and again.
Outlook and prognosis
When medical care is sought, the prognosis of a brain abscess is favorable. The administration of medications results in a regression of pus production as well as a drainage of the accumulated pus. The abscess is usually completely removed in surgery or by other techniques, and the symptoms gradually resolve completely. If no further complications occur and there are no further health impairments, the patient can normally be discharged from treatment within a few weeks, free of symptoms. Since surgery is always associated with risks and side effects, there is still a risk of injury to healthy tissue when the abscess is removed. General as well as specific functional disorders may occur as a result or irreparable damage to the brain may be caused, depending on the location of the injuries. If medical help is refused by the patient, the probability of premature death increases immediately. The accumulation of pus continues to spread in the brain and the abscess can significantly expand its circumference as it continues to develop. In addition to sepsis, the affected person is threatened with bursting of the surrounding vessels. This poses a danger to life. The affected person may fall into a coma or suffer irreparable functional disorders. Modern medical options have increased the survival rate for a brain abscess to over 95%.
Prevention
To prevent brain abscesses, infections especially around the brain but also in all other areas of the body should be treated and completely cured to avoid transmission of pathogens to the brain. Taking antibiotics until the end of the treatment is essential for this. In any case, it is advisable to pay attention to a healthy lifestyle with a balanced diet and sufficient exercise. The better the condition of a body, the better it can also recover in case of illness.
Aftercare
After surgical removal of a brain abscess, further follow-up is based on where and how large the abscess was. If the abscess capsule was completely removed, no damage need remain. It is important for the patient’s recovery that the nervous system has not been damaged. However, epilepsies often occur following surgery. In addition, there is a risk that a brain abscess will occur again. Follow-up care after treatment should ensure that infections are avoided, as these would increase the risk of recurrence. Patients can work to limit the transmission of pathogens in accordance with the physician’s recommendations. This includes providing targeted therapy for infectious diseases. Dangerous bacterial diseases include, for example, inflammation of the sinuses or middle ear. When receiving antibiotic therapy, patients should take these drugs consistently and follow medical instructions. Early discontinuation is not recommended, because the bacteria must be completely combated. With a health-conscious lifestyle, which includes a vitamin-rich diet, sufferers also boost their defenses. Exercise also helps the body better manage inflammation and recover.
Here’s what you can do yourself
A brain abscess is a collection of pus in the brain. Affected individuals have limited options they can take to get better with this condition. Seeing a doctor early is very important and significant, as it is the only way to ensure a smooth and complete recovery. After drug and medical treatment, strict bed rest is very important. The strengthening of the immune system in the subsequent healing process should also not be neglected, because only in this way can a brain abscess heal without any complications. In addition, affected persons can pay attention to a healthy and balanced diet. This strengthens the entire body and allows it to recover much better and faster in the event of a new infection. Thus, only limited measures can be taken in advance that will lead to an improvement in an existing brain abscess.Subsequently, strengthening the immune system is very important. In this way, affected individuals can avoid dangerous complications, so that a much more pleasant course of the disease can be expected. In addition, accurate and early diagnosis is very important so that appropriate treatment can be initiated.
