Brain Abscess
A brain abscess or cerebral abscess is a collection of pus fluid that develops in the brain due to a focal infection in the brain parenchyma. Initially, the infection is localized in the cerebellar area, but over time it becomes a collection of pus in a well-vascularized capsule. This condition can cause swelling in the brain, thus disrupting some brain functions.
Symptoms of Brain Abscess
Symptoms usually appear slowly over several weeks, but they can also appear suddenly. Symptoms that can appear are:
1. Changes in consciousness, such as becoming unconscious, confused, and unresponsive to commands.
2. Decreased speech function.
3. Sensation is reduced.
4. Decreased muscle movement and function.
5. Decreased visual acuity.
6. Vomit.
7. Fever.
8. Stiffness in the neck.
Risk Factors for Brain Abscess
Almost anyone can get it, but some people are at greater risk than others.
Some conditions that can increase the risk of brain abscesses, namely:
1. Having a weak immune system, for example, due to having HIV/AIDS, undergoing chemotherapy, or taking immunosuppressant drugs.
2. Having endocarditis, pneumonia, bronchiectasis, and other lung infections or conditions, abdominal infections, cystitis, and other pelvic infections.
3. Having a serious head injury or a fractured skull.
4. Having sinus infections, chronic middle ear infections, meningitis, and dental abscesses.
Causes of Brain Abscess
The cause of a brain abscess is usually a bacterial or fungal infection. If the immune system is unable to kill the infection, it will limit the spread of the infection by using healthy tissue to stop the pus from infecting other tissue. However, this actually causes an abscess to form.
Brain infections are rare because the body has developed defenses to protect the brain. One of these is the blood-brain barrier, a thick membrane that filters impurities from the blood before allowing them to enter the brain.
Although the exact location of the infection cannot always be identified, it is usually in the skull, bloodstream, or after a head injury.
1. Infection in the skull
A brain abscess can occur as a complication of an infection around the skull, such as:
1. Persistent middle ear infection (otitis media).
2. Sinusitis, which is an infection of the sinuses, the air-filled cavities in the cheekbones and forehead.
3. Mastoiditis, an infection of the bone behind the ear.
This used to be the leading cause of brain abscesses, but as treatments for the infection have improved, brain abscesses have become a rare complication.
2. Infection through the bloodstream
Infections can spread through the blood, causing a brain abscess. People with a weak immune system are at high risk of developing a brain abscess from a blood-borne infection. This is because the immune system may not be able to fight off the infection at first.
A person may have a weakened immune system if:
1. Having a medical condition that weakens the immune system, such as HIV/AIDS.
2. Undergoing medical treatments that can weaken the immune system, such as chemotherapy.
3. Having an organ transplant and taking immunosuppressant drugs to prevent the body from rejecting the new organ.
Meanwhile, infections and health conditions that can cause brain abscesses are:
1. Cyanotic heart disease, a type of congenital heart disease, occurs when the heart is unable to carry enough oxygen throughout the body. If the body is deprived of oxygen, it is more susceptible to infection.
2. Pulmonary arteriovenous fistula, a rare condition in which an abnormal connection develops between blood vessels in the lungs. This allows bacteria to enter the blood and eventually the brain.
3. Dental abscess or treatment for tooth decay.
4. Lung infections, such as pneumonia or bronchiectasis.
5. Having a heart infection, such as endocarditis.
6. Skin infection
7. There is an infection in the abdomen, such as peritonitis (infection of the intestinal lining).
8. Having a pelvic infection, such as an infection of the lining of the bladder (cystitis).
3. Infection after head injury
Direct trauma to the skull can also cause a brain abscess. The most common causes are:
1. Skull fracture caused by penetrating head injury.
2. Gunshot or shrapnel wounds to the brain.
3. Complications after neurosurgery are possible, but they are rare.
Brain Abscess Diagnosis
The diagnosis is made by delving deeper into the symptoms felt by the sufferer. The doctor then performs a complete neurological examination. The examination describes whether or not there is brain pressure due to an abscess. Several supporting examinations can be performed to help establish the diagnosis, namely:
CT Scan and MRI imaging, are used to see if there is abscess formation in the brain.
Lumbar puncture is used to take a sample of cerebrospinal fluid from the spine. This cerebrospinal fluid is then examined microscopically to determine the cause of the brain abscess.
Brain Abscess Treatment
Antibiotics can be used to treat this disease. Especially in abscesses less than 2.5 centimeters from the head. Surgery is performed if antibiotic therapy fails. This can also be done if there is a risk of rupture of the abscess sac in the brain.
Brain Abscess Prevention
Brain abscess is a serious condition. This health condition can be prevented by maintaining personal and environmental hygiene to avoid getting an abscess. Some ways to reduce the risk of a brain abscess include:
Medical procedures, such as tooth extraction or other dental procedures, need to be carried out carefully to prevent infections that can trigger brain abscesses.
Post-procedural or medical care, post-procedural care that is carried out carefully and taking into account sterility aspects.
Regular check-ups for chronic diseases, such as heart disease or diabetes.
Complications of Brain Abscess
Complications that can occur include:
1. Recurrent abscesses. This is more common in people with weakened immune systems or cyanotic heart disease.
2. Brain damage. Mild to moderate brain damage may improve over time, but severe brain damage tends to be permanent. These complications of a brain abscess are more likely to occur if diagnosis and treatment are delayed.
3. Epilepsy, which causes a person to have repeated seizures.
4. Meningitis, is a life-threatening infection of the protective membranes around the brain that requires immediate treatment. It is more common in children.