Brain abscess or cerebral abscess is an abscess caused by the infection especially caused by bacteria in the tissue of brain. Brain abscess is an inflammation and collection of infected material that are entering brain from local infected areas such as ear infection, dental abscess, infection from paranasal sinuses, infection from the mastoid cells in the temporal bone or from epidural abscess or infection coming from remote parts of the body such as lungs, heart, kidney, or infection sources within the brain tissue.
The brain is a special organ which is protected from infection by bacteria and is protected by skull, the meninges (layers surrounding the brain), the immune system and highly regulated barrier between the blood stream and the brain.
In some condition due to any defect in these barriers, the bacteria enter the brain and cause localized infection and form abscess.
Infection travel to the brain through the following given routes
Trauma in which there occurs open skull fracture allows organisms to enter the brain directly. Brain abscess can also occur in post operative cases where there occurs infection after the surgery. Rarely there occurs brain abscess after trauma to the face.
Direct entry of infection to the brain tissue occurs from the travelling of infection from the necrotic areas of the Osteomyelitis in the posterior wall of the frontal sinus as well as from sphenoid sinuses and ethmoid sinuses. These routes of infection are related the sub acute and chronic otitic infection and mastoiditis.
Spread from the route of blood from distant places
Through this route infection travel to brain through blood and generally abscess are found near the distribution of the cerebral artery. In this type most common sites of occurrence of abscess are frontal lobe, temporal lobe parietal lobe of the cerebrum.
Age / Sex of Brain Abscess
Brain abscess occurs more commonly in males than in females.
Young children and infants are more prone to develop brain abscess because of more occurrence of meningitis in small children.
Brain abscess cases are rare in developed countries but are more common in developing countries.
There is not particular race which develop brain abscess but can occur in individuals of any race.
Following are the predisposing factors
• Dental infections by aerobic and anaerobic streptococci.
• Ear infections such as mastoiditis by haemophillus bacteria.
• Infection of the heart that is endocarditis by staphylococcus aureus.
• Liver abscess by klebsiella pneumonia.
• In any penetrating trauma infection by enterobacteriaceae, staphylococcus aureus.
Organisms that cause infection and lead to formation of abscess are as follows
• Staphylococcus aureus.
• Prevotella and Fuscobacterium species.
• Pseudomonas species.
• Anaerobes especially Veillonella and Eubacterium
• Enterobacteriaceae especially Klebsiella pneumonia, Escherichia coli and Proteus species.
Less common organisms causing brain abscess are as follows
• Nocardia asteroids.
• Helminthes such as Taenia solium.
• T gondii.
• Actinobacillus actinomycetemcomitans.
• Haemophilus aphrophilus.
• Other enterobacteriacea are actinobacillus, actinomycetemcomitans, and Salmonella species.
• Nocardia asteroids.
• Fungi such as aspergillus, candida, Cryptococcus.
• Neisseria meningitidis.
• H influenza.
There are changes in mental status and the changes are as follows
• Slow in thought process.
• Decreased responsiveness.
• Eventually coma will develop.
Other symptoms are as follows
• Decreased movement.
• Fever and chills.
• There are difficulties in languages.
• Loss of coordination occurs.
• Loss of muscle function, especially on one side.
• Seizures can occur.
• Stiffness in neck.
• Vision changes occur.
• Decreased speech.
• Focal encephalitis.
• Epidural abscess.
• Bacterial meningitis.
• Brain cancer.
• Mycotic aneurysm.
• Septic cerebral emboli causing infarction.
• Septic dural sinus thrombosis.
• Blood culture.
• Complete blood count.
• Chest X-ray.
• CT scan of brain is done to find the location of abscess.
• Lumbar puncture is done and then CSF (cerebro spinal fluid) is cultured and type of bacteria involved in infection is found.
• Magnetic resonance imaging of the brain is done.
• Testing of antibodies in blood.
If abscess is treated before the person goes into coma stage then prognosis is good.
In cases where infection is severe can also lead to death of the patient.
Early treatment and good diet treat the case early.
• Antibiotics will help.
• Surgery in done in rare cases if intracranial pressure is increased.
• Brain damage.
• Meningitis that is severe and life threatening.
• Recurrence of infection.
•Well indicated medicine for brain abscess.
•Head is hot with cold body, senstiveness of brain with sharp pinching pains.
•Scalp feels contracted.
•Cold spot on forehead.
•Patient complains of chronic vertigo, objects whirl about especially when walking.
•Very well indicated medicine for brain abscess.
•Head is sensitive to least contact.
•Patient complains of pain,fullness, especially in forehead,also occiput and temples.
•Headache from suppressed cattarhal flow.
•There are palpitation reverberating in head with labored breathing.
•Crotalus horridus is also a very good medicine to treat brain abscess.
•Patient complains of dull heavy occiputal pain on right side and right eye.
•Headache with pain in heart on lying on left side.
•Headache, must walk on tip-toe to avoid jarring
•Patient complains of throbbing pain,rush of blood and feeling of tight band.
•Vertigo worse from stooping,worse in warm room.
•Chronic,congestive headache of old people.
•Help in treating cases of brain abscess.
•This medicine is also well indicated for brain abscess.
•Pain through head on awaking.
•There is pressure and burning on vertex.
•Also indicated for sun headaches.
•Relieved by onset of discharge(menses or catarrh).
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