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Condition/Disorder Synonym

  • Cerebral abscess

ICD-9-CM Codes

  • 324.0 Intracranial abscess

ICD-10-CM Codes

  • G06.0 Intracranial abscess and granuloma

  • G06.2 Extradural and subdural abscess, unspecified

Preferred Practice Patterns

Key Features


  • 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 the following:

    • - 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.


  • All ages and genders, who experience one of the contributing causes, are at risk for developing a brain abscess.

  • Approximately 60% of children who develop a brain abscess have congenital heart disease.

Clinical Findings

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, activities of daily living (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 arteriovenous malformation

  • Surgical trauma

  • Cranial injury

Differential Diagnosis

Means of Confirmation or Diagnosis

Laboratory Tests

  • Sedimentation rate

  • Cerebrospinal fluid (CSF) pressure

  • Mild-to-moderate pleocytosis

  • Complete blood count (CBC)


  • Computed tomography (CT) with contrast

  • Magnetic resonance imaging (MRI)

Findings and Interpretation

  • Blood protein moderately elevated

  • Elevated sedimentation rate

  • Moderately increased cerebrospinal fluid (CSF) pressure



  • Antibiotics, usually intravenous, for several weeks

  • Intravenous mannitol or dexamethasone to prevent cerebellar ...

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