Brain abscess (brain abscess)

A Brain abscess or Brain abscess is a build-up of pus in the brain. The cause is my limited and locally fixed infection in the brain. Without antibiotic therapy, the death rate from brain abscesses would be very high.

What is a brain abscess?

A Brain abscess or Brain abscess is a local infection of the brain that creates a collection of pus that encapsulates into an abscess.

When certain areas of the brain tissue become inflamed, a body cavity forms in the core of the inflammatory focus, which is created by melting down the local tissue. The inflammation causes pus to form, which is collected in this newly created cavity. When the collection of pus becomes encapsulated, an abscess is formed.

A brain abscess occurs very rarely with a probability of 1 in 100,000. Most common brain abscesses 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 and abscesses in the cerebellum rarely occur. In any case, a brain abscess must be treated medically.

causes

Brain abscesses arise from infections. As a rule, these are infections of bacterial origin. In half of all brain abscesses caused by bacterial infections, the bacteria come from infections in other, nearby areas of the body.

The origin of a brain abscess can therefore be diseases such as otitis media or sinus infections that have not been properly cured. The other half of all abscesses are often caused by infections in more distant areas of the body, when bacteria enter the brain from here via the bloodstream. Injuries to the brain from accidents or operations can also result in brain abscesses.

Fungi or other non-bacterial pathogens are a possible cause, albeit with a very low probability. To do this, however, other factors must also occur at the same time that favor a brain abscess, such as an already weakened immune system.

Symptoms, ailments & signs

The symptoms of a brain abscess depend on which area of ​​the brain the abscess is located in. The size of the abscess also plays a big role. Initially, the symptoms tend to be unspecific. Headache, nausea and vomiting are some of the main complaints.

These symptoms are caused by the increased pressure caused by the abscess itself and the brain edema. Therefore, they are also referred to as so-called intracranial pressure symptoms. Further symptoms depend on the location of the brain abscess. This can lead to disorders of consciousness as well as so-called cerebral focus symptoms. The cerebral focus symptoms include visual disturbances, speech disorders, swallowing disorders or paralysis.

Sometimes a brain abscess is also accompanied by epileptic seizures and fever. Around 50 percent of all those affected suffer from a fever. A brain abscess is generally a life-threatening condition. This allows the abscess capsule to press on neighboring regions of the brain. How dangerous this pressure is depends on which body functions are controlled there.

The inflammation can also spread to other areas of the brain. A particularly life-threatening condition is when there is inflammation in the space between the hard meninges and the periosteum of the skull. However, this is rarely the case.

Overall, mortality from brain abscesses has now fallen to five to ten percent. In severe cases, long-term damage such as epileptic seizures and other neurological problems are possible even after successful treatment.

Diagnosis & course

A Brain abscess develops at different speeds depending on the cause and physical condition. The incubation period can therefore be only a few weeks in the case of accidents up to 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 accompanied by nausea, vomiting and fever. Depending on where the brain abscess is located, it can also trigger epileptic seizures, and now and then also speech, visual and movement disorders.

Often, after a brain abscess, what is known as edema also develops due to the increased accumulation of fluid in the immediate vicinity. If a brain abscess is suspected, a laboratory blood test is usually done first to check for any signs that might suggest a brain abscess. These include increased levels of inflammation with antibodies against the pathogens underlying the inflammation, which can be detected in the blood.

If the suspicion of a brain abscess is confirmed, imaging methods are used. With computer tomography or magnetic resonance tomography (MRT), brain abscesses can be made visible and thus confirmed.

Complications

A brain abscess is a very serious health condition that can lead to death without treatment. For this reason, a brain abscess must always be examined and treated by a doctor. As a result of this disease, bodily functions are restricted. Which regions and functions are affected, however, depends on the severity of the infection.

In most cases, however, people suffer from headaches and vomiting. Furthermore, there is nausea and not infrequently migraine attacks. Without treatment, sensitivity disorders and paralysis occur, which can also lead to epileptic seizures. The patient's vision is also reduced by the brain abscess, causing movement disorders and coordination disorders.

Likewise, the patient's actions and thinking are restricted and there is a general level of adeptness. The quality of life decreases extremely and the patient is dependent on the help of other people due to the illness. 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, consequential damage can be avoided.

When should you go to the doctor?

If massive headaches and nausea keep recurring, you may have a brain abscess. A doctor's visit is recommended if the symptoms persist for more than a week and cannot be attributed to a specific cause. If the symptoms worsen rapidly and develop into a severe migraine, medical advice is required. The sudden occurrence of epileptic seizures or speech, vision and movement disorders also indicate a serious condition that needs to be clarified.

A brain abscess is often associated with a middle ear or sinus infection that has not been properly cured. Infections in other parts of the body as well as injuries to the brain from surgery or accidents can also cause abscesses in the brain. Anyone who belongs to these risk groups should immediately consult a doctor with the symptoms mentioned. Pregnant women, the elderly and children should always see a doctor with persistent headaches and nausea. In addition to the family doctor, those affected can also speak to a neurologist or a specialist in internal medicine.

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Treatment & Therapy

A Brain abscess usually has to be removed surgically, but in individual cases depends on various factors such as the cause, location, size and number of the abscess or abscesses and the condition of the patient.

Brain abscesses in the upper layers of the brain are usually removed by surgery as quickly as possible. In the case of brain abscesses in deeper and hard-to-reach areas, some preparatory measures are usually carried out before an operation. Usually abscesses are punctured through a drill hole in an initial procedure, the accumulated pus is drained and the abscess cavity is rinsed. The remaining capsule is then removed during a second procedure.

In addition to the therapy, the pathogens and the causative infections are treated in order to prevent new abscess formation. If an operation is impossible for various reasons or several very small abscesses have formed, a treatment method based purely on antibiotics can also be chosen. Due to medical progress, very few brain abscesses are fatal.

Most patients recover completely without permanent damage after successful removal of the abscess. In some cases, however, the abscesses cause irreparable damage to the nervous system. Epilepsies are particularly common here. In addition, in some cases, brain abscesses keep recurring.

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Outlook & forecast

When seeking medical care, the prognosis of a brain abscess is favorable. The administration of medication leads to a regression of the production of pus and a removal of the accumulated pus. The abscess is usually completely removed in a surgical procedure or by other techniques and the symptoms gradually recede completely. If there are no further complications and no further health impairments are present, the patient can normally be discharged from treatment free of symptoms within a few weeks.

Since an operation is always associated with risks and side effects, there is still the risk of damaging healthy tissue when the abscess is separated. Depending on the location of the injury, this can lead to general and specific functional disorders or irreparable damage to the brain.

If the patient refuses medical help, the immediate likelihood of premature death increases. The accumulation of pus spreads further in the brain and the abscess can expand its size significantly as it continues to develop. In addition to sepsis, there is a risk that the surrounding blood vessels will burst. This is life threatening. The affected person can fall into a coma or suffer irreparable dysfunction. Thanks to modern medical possibilities, the survival rate for a brain abscess has risen to over 95%.

prevention

Around Brain abscesses To avoid infections, especially in the area around the brain, but also in all other parts of the body, should be treated and completely cured in order to avoid the pathogen being transmitted to the brain. Taking antibiotics until the end of treatment is essential for this. In any case, it is advisable to maintain a healthy lifestyle with a balanced diet and sufficient exercise. The better the body's condition, the better it can recover in the event of illness.

Aftercare

After the surgical removal of a brain abscess, the further course depends on where and how large the abscess was. If the abscess capsule has been completely removed, no damage need be left behind. For the patient to recover, it is important that the nervous system has not been damaged. However, epilepsy often occurs after surgery. In addition, there is a risk of another brain abscess.

Follow-up care after treatment is designed to ensure that infections are avoided, as these would increase the risk of relapse. The patients can work to contain the transmission of pathogens according to the doctor's recommendations. This includes targeted treatment of infectious diseases. Dangerous bacterial diseases include, for example, inflammation of the sinuses or the middle ear.

In antibiotic therapy, those affected should consistently take these drugs and adhere to medical instructions. An early termination is not recommended, because the bacteria must be completely fought. With a health-conscious lifestyle, which includes a diet rich in vitamins, those affected also increase their immune system. Exercise also helps the body cope with inflammation and recover.

You can do that yourself

A brain abscess is a collection of pus in the brain. Affected people can only take limited possibilities to bring about an improvement with this clinical picture. Going to the doctor at an early stage is very important and significant, because this is the only way to ensure a smooth and complete recovery.

After medication 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 this is the only way to heal a brain abscess without any complications. In addition, those affected can ensure a healthy and balanced diet. This strengthens the entire body and can recover much better and faster in the event of a renewed infection. Thus, only limited measures can be taken in advance that lead to an improvement in an existing brain abscess.

Afterwards, strengthening the immune system is very important. In this way, affected persons can avoid dangerous complications, so that the course of the disease can be expected to be much more pleasant. In addition, an accurate and early diagnosis is very important so that appropriate treatment can be initiated.