Brain Abscess

A brain abscess, or cerebral abscess, is a buildup of pus in the brain due to infection. Brain abscesses are often caused by a bacterial or fungal infection in the brain triggered by a head injury or an infection in another area of the body that spreads to the brain. 

Brain abscesses are often marked by the appearance of severe headaches, fever, seizures, and even disturbances of consciousness. This condition is dangerous because it can cause swelling of the brain, so it requires fast and appropriate treatment. 

brain abscess

Causes of Brain Abscesses

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 other organs. 

The type of bacteria that most often causes the accumulation of pus in the brain comes from the Bacteriode, Streptococcus, Staphylococcus, or Enterobacter groups. Meanwhile, 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 as a result of suffering from HIV/AIDS, cancer, or using immunosuppressive drugs,
• Have a middle ear infection (otitis media), an infection of the ear bones (mastoiditis), sinusitis, a tooth abscess, or meningitis
• suffered from a head injury, skull fracture, or had surgery on the head or neck
• Suffering from lung infections, endocarditis, infections in the abdominal cavity, pelvic infections, or skin infections
• Suffer from congenital heart disease (CHD) or abnormalities in the pulmonary arteries or pulmonary arteriovenous fistula

Brain abscess symptoms

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

Following are some of the symptoms of a brain abscess:

• Persistent headaches
• Neck or back feels stiff
• Nausea and vomiting
• High fever
• shivers
• seizures
• Impaired nerve function, such as muscle weakness, paralysis, or slurred speech
• Changes in behavior, such as restlessness or confusion
• Visual disturbances, such as double, blurred, or blurry vision

When to see a doctor

See a doctor immediately if you experience the symptoms mentioned above, especially if a severe headache is accompanied by high fever, seizures, muscle paralysis, or difficulty speaking. A brain abscess must be treated quickly and precisely to prevent life-threatening complications for the patient. 

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

Diagnosis of brain abscess

To diagnose a brain abscess, the doctor will ask and answer questions about the symptoms as well as the patient's medical and family history. Next, the doctor will carry out a thorough physical examination, including a neurological examination (neurology). 

The doctor will also carry out supporting examinations to confirm the diagnosis and determine the cause of a brain abscess. Some of the checks that will be carried out are:

• Blood test to detect signs of infection from the level and number of blood cells
• Scan with X-rays, a CT scan, or an MRI to find out the location and size of the brain abscess.
• Biopsy is used to identify changes in cells and tissues in the brain as well as to find out the pathogens that cause brain abscesses.
• Lumbar puncture to identify pathogens, including types of bacteria that cause brain abscesses
• blood culture to find out the bacteria or fungus that causes a brain abscess.
• Record brain waves, or an electroencephalogram (EEG), to determine electrical activity in the brain, especially in brain abscess patients who experience recurrent seizures.

If a brain abscess is suspected of originating from an infection in another part of the body, such as the respiratory tract, a sputum culture can be done to determine the type of germ that infects the lungs. 

Brain Abscess Treatment

A brain abscess needs to be treated as soon as possible. The method of treatment depends on the size, number, and type of bacteria or germs that cause the abscess in the brain. 

Treatment of a brain abscess also aims to relieve complaints and prevent complications. Some of the treatment methods that doctors can use are:

Drugs

Medicines 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 to treat brain abscesses caused by toxoplasmosis
• Diuretics and corticosteroids reduce pressure and swelling in the brain.
• Anti-seizure drugs are used to treat seizures that can occur in brain abscesses.

Operation

Surgery will be performed if the abscess is larger than 2 cm or if there is a risk of the abscess bursting and damaging the surrounding brain tissue. The goal of surgery is to remove the abscess. 

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

Simple aspirations

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

Craniotomy

In a craniotomy, the doctor will remove a small part of the skull (the flap) so he can access 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. 

Brain abscess complications

A brain abscess has the potential to cause the following complications:

• The abscess recurred
• Damage to brain tissue
• Epilepsy
• Meningitis
• Sinusitis
• Infection of the bone behind the ear (mastoiditis)
• Brain swelling
• Sepsis
• Coma
• Death

Brain abscess prevention

The best way to prevent a brain abscess is to avoid its cause. Some ways that can be done are:

• Undergo examination and treatment to completion if suffering from an infectious disease.
• Maintaining the health and hygiene of the teeth and mouth, including by checking with the dentist regularly,
• Use protective equipment, such as a helmet, when working in an environment where there is a risk of head injury.
• Applying healthy sexual behavior to avoid transmission of HIV/AIDS
• Living a healthy lifestyle, such as quitting smoking, eating healthy, balanced, nutritious food, and exercising regularly,
• Do not take drugs carelessly.
• Get vaccinated to prevent certain bacterial infections, such as meningitis, pneumonia, and Hib.

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