Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Condition/Disorder Synonym ++ Cerebral abscess +++ ICD-9-CM Codes ++ 324.0 Intracranial abscess +++ ICD-10-CM Codes ++ G06.0 Intracranial abscess and granulomaG06.2 Extradural and subdural abscess, unspecified +++ Preferred Practice Patterns1 ++ 5C: Impaired motor function and sensory integrity associated with nonprogressive disorders of the central nervous system – congenital origin or acquired in infancy or childhood5D: Impaired motor function and sensory integrity associated with nonprogressive disorders of the central nervous system – acquired in adolescence or adulthood +++ Key Features +++ 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 craniumMay be secondary to infectious process elsewhere in the body includingParanasal sinus (rhinogenic): usually leads to abscess in frontal and temporal lobesMiddle ear (otogenic): usually leads to abscess in anterolateral cerebellum, middle and inferior temporal lobePulmonary infectionBacterial endocarditisRupture of abscess can advance to irreversible coma +++ General Considerations ++ Approximately 50% are metastaticApproximately 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 abscess60% of children who develop a brain abscess have congenital heart disease +++ Clinical Findings +++ Signs and Symptoms ++ HeadacheDrowsinessConfusionFocal or generalized seizureFocal motor, sensory, or speech disturbanceFever (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-careImpaired ability to interact with others effectivelyDifficulty with cognitive processing, particularly executive function +++ Possible Contributing Causes ++ Bacterial endocarditisPulmonary infectionSinus infectionMiddle-ear infectionCongenital heart diseaseInfected pelvic organsInfected tonsilsAbscessed teethOsteomyelitisPulmonary ateriovenous malformationSurgical traumaCranial injury +++ Differential Diagnosis ++ StrokeBrain tumorSubdural empyema +++ Means of Confirmation or Diagnosis +++ Laboratory Tests ++ Sedimentation rateCerebrospinal fluid (CSF) pressureMild to moderate pleocytosisComplete blood count (CBC) +++ Imaging ++ CT with contrastMRI +++ Findings and Interpretation ++ Blood protein moderately elevatedElevated sedimentation rateModerately increased cerebrospinal fluid (CSF) pressure +++ Treatment +++ Medication ++ Antibiotics, usually intravenous, ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.