Skip to Main Content

++

  • Cerebral abscess

++

  • 324.0 Intracranial abscess

++

  • G06.0 Intracranial abscess and granuloma
  • G06.2 Extradural and subdural abscess, unspecified

++
++

Description

++

  • Confined area of infection within the cranium

++

Essentials of Diagnosis

++

  • Greater than 90% of brain abscesses due to external causes: compound fracture of skull, bullet wound, surgical complication involving brain or cranium
  • May be secondary to infectious process elsewhere in the body including
    • Paranasal sinus (rhinogenic): usually leads to abscess in frontal and temporal lobes
    • Middle ear (otogenic): usually leads to abscess in anterolateral cerebellum, middle and inferior temporal lobe
    • Pulmonary infection
    • Bacterial endocarditis
  • Rupture of abscess can advance to irreversible coma

++

General Considerations

++

  • Approximately 50% are metastatic
  • Approximately 20% cannot be traced to site of origin

++

Demographics

++

  • All ages and genders, who experience one of the contributing causes, are at risk for developing a brain abscess
  • 60% of children who develop a brain abscess have congenital heart disease

++

Signs and Symptoms

++

  • Headache
  • Drowsiness
  • Confusion
  • Focal or generalized seizure
  • Focal motor, sensory, or speech disturbance
  • Fever (inconsistent)
  • Leukocytosis (inconsistent)
  • Increased intracranial pressure (later in the course of illness)
  • Papilledema (later in the course of illness)

++

Functional Implications

++

  • Loss of independence with all aspects of mobility, ADLs, self-care
  • Impaired ability to interact with others effectively
  • Difficulty with cognitive processing, particularly executive function

++

Possible Contributing Causes

++

  • Bacterial endocarditis
  • Pulmonary infection
  • Sinus infection
  • Middle-ear infection
  • Congenital heart disease
  • Infected pelvic organs
  • Infected tonsils
  • Abscessed teeth
  • Osteomyelitis
  • Pulmonary ateriovenous malformation
  • Surgical trauma
  • Cranial injury

++

Differential Diagnosis

++

  • Stroke
  • Brain tumor
  • Subdural empyema

++

Laboratory Tests

++

  • Sedimentation rate
  • Cerebrospinal fluid (CSF) pressure
  • Mild to moderate pleocytosis
  • Complete blood count (CBC)

++

Imaging

++ ++

  • Blood protein moderately elevated
  • Elevated sedimentation rate
  • Moderately increased cerebrospinal fluid (CSF) pressure

++

Medication

++

  • Antibiotics, usually intravenous, for several weeks
  • Intravenous Mannitol or dexamethasone to prevent cerebellar herniation and temporal-lobe damage

++

  • To emergency room physician if emergency identified
  • To neurologist or neurosurgeon for diagnosis and treatment of infection
  • To neuropsychologist for cognitive testing after resolution of the active infection
  • To physiatrist for specific rehabilitation if residual neurologic deficit requires rehabilitation
  • To occupational therapist for ADL, cognitive, and fine-motor task retraining
  • To speech/language pathologist for speech, cognition, and swallowing impairments
  • To respiratory therapist as ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.