A brain abscess is a collection of infectious material within the brain tissue. It can result from direct invasion from trauma or surgery, spread of nearby infection, or infection from other organs. Common causes include lung abscesses or infective endocarditis. Organisms enter the brain through extension or bloodstream spread. Patients experience headaches, vomiting, focal neurological deficits, and possible altered mental status or seizures. Diagnosis involves repeated neurological exams along with CT or MRI scans. Treatment is with long-term intravenous antibiotics and sometimes surgery to drain the abscess. Nursing care focuses on neurological monitoring, medication administration, monitoring response to treatment, and providing supportive care to the severely ill patient and their family.

1. BRAIN ABSCESS
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. Definition
• A brain abscess is a collection of infectious
material within the tissue of the brain.
• Although brain abscess is relatively rare, it is a
complication encountered increasingly in
patients whose immune systems have been
suppressed either through therapy or disease

3. CAUSES
• direct invasion of the brain from intracranial
trauma or surgery
• by spread of infection from nearby sites
• infection from other organs (lung abscess,
infective endocarditis)

4. PATHOPHYSIOLOGY
• Entry of organisms into the brain –
• extension or hematogenous
spread.
• Hematogenous of multiple abscesses and
abscesses arising from the grey-white junction.

5. • Increased permeability of the blood-brain
• It allows for better penetration of antibiotics
and causes ring enhancement of the abscess on
scans.

6. Clinical Manifestations
• intracranial dynamics (edema, brain shift),
infection, or the location of the abscess .
• Headache,.
• Vomiting.
• Focal neurologic signs (weakness of an
extremity,
decreasing vision, seizures)

7. • There may be a change in mental status,
as reflected in lethargic, confused, irritable,
or disoriented behavior.
• Fever may or may not be present.

8. Assessment and Diagnostic Findings
• Repeated neurologic examinations and
continuing assessment
• A computed tomography (CT) scan
• A magnetic resonance imaging (MRI) scan

9. Medical Management
• antimicrobial therapy and surgical incision or
aspiration.
• If the abscess is encapsulated,
• Antimicrobial treatment is prescribed to
eliminate the causative organism or reduce its
virulence.

10. • Penicillin G (20 million U) and
chloramphenicol (Chloromycetin) (4 to 6 g/day
given intravenously.
• Corticosteroids may be prescribed

11. • Antiseizure medications (phenytoin,
phenobarbital) may be prescribed to prevent
seizures.
• Multiple abscesses may be treated with
appropriate antimicrobial therapy alone, with
close monitoring by CT scans.

12. Nursing Management
• assessment of the neurologic status,
administering medications, assessing the
response to treatment, and providing supportive
care.
• Ongoing neurologic
• The nurse also assesses and documents the
responses to medications.

13. • Blood laboratory test results, specifically blood
• glucose and serum potassium levels,
• Medical intervention may
• Injury may result from decreased level of
consciousness and falls related to motor weakness
or seizures.

14. • The patient with a brain abscess is extremely ill,
and neurologic deficits
• family’s ability to express their distress at the
patient’s condition, cope with the patient’s
illness and deficits, and obtain support.

15. Summary
• So far we have discussed about
definition, causes, pathophysiology. Clinical
manifestation, diagnostic measures, and
management of brain abscess.

16. Bibliography
• Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7th edition.
• Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
• Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.

17. Thank You