Abscess

Cerebral abscess is an infection of the brain that is accompanied by headache, fever and / or focal symptoms. The etiology in most cases is due to nearby infection and more rarely from craniocerebral injury and intracranial surgery. The abscess appears more commonly at the grey-white matter junction. The most common organisms responsible for the development of infection are streptococci, staphylococci and anaerobic bacteria, either alone or in combination.

Symptoms

• Headache
• Drowsiness
• Confusion
• Fever
• Speech disorders
• Vomiting
• Fatigue
• Epileptic seizures

The Symptoms and findings depend largely on the specific location of the abscess in the brain. An abscess in the cerebellum, for example, can cause additional side effects such as hydrocephalus and pressure on the brain stem.

It is easily diagnosed by CT scan.

Indications for surgical intervention

Initially conservative therapy is preferred with appropriate chemo-prophylaxis, anti-inflammatory and anti-seizure treatment. If this does not yield the desired and / or expected results, then surgical intervention is imperative. Surgical drainage also offers a permanent solution in cases where the clinical presentation of the patient has worsened.

The treatment depends on the location of the abscess. In the speech, motion or sensory cortex area and deeper lesions stereo-tactic drainage of the abscess and biopsy to obtain specimens for culture to identify the pathogens is preferred.

For abscesses near the cortex and relatively easily accessible areas , craniotomy is preferred to drain the abscess capsule  thus  minimizing the risk of recurrence of the abscess provided that the risk of hemorrhage can be avoided during removal of the capsule .