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DEEPAK KRISHNA
BRAIN ABSCESS
Introduction:
A brain abscess is a
collection of pus enclosed
in the brain tissue, caused
by a bacterial or fungal
infection which occurs in
patients whose immune
system have been
Definition
Brain abscess is
defined as purulence
and inflammation in one
or more localized
regions within the brain
parenchyma.
Etiology
Streptococci and
staphylococcus
aureus are the
primary infective
organisms.
risk factors:
 Clients with compromised
immune system due to HIV
or AIDS(Toxoplasmosis
gondii)
Cancer and other chronic
illnesses
Congenital heart disease
Cont…
Meningitis
Immunosuppressant
drugs, such as those used
in chemotherapy
Chronic sinus or middle
ear infections
Pathophysiology
It may occur by direct invasion
of the brain from intracranial
trauma or surgery; by spread of
infection from nearby sites, such
as the sinuses, ears, and teeth
(paranasal sinus infections,
otitis media, dental sepsis); or
by spread of infection from other
Clinical manifestation
Fever
Headache
Neck stiffness
Nausea and vomiting
Signs of increased ICP may
include drowsiness, confusion
and seizures.
Decreased movement
Cont…
Decreased sensation
Decreased speech
(aphasia)
Hemiparesis
Ataxia (Loss of
coordination)
Visual field defects
Nystagmus
Diagnostic evaluation
 Neurological examination shows sings
of increased intracranial pressure and
problems with brain function.
 Blood cultures
 Chest x-ray
 Complete blood count (CBC)
 Head CT scan
 Electroencephalogram (EEG)
 MRI of head
Stereotactic Needle biopsy
 A needle biopsy is usually performed to
identify the cause of the infection.
Medical management
Antimicrobial therapy
IV Antibiotics(Eg:
combination drug with
Pencillin G and
metrondizole).
Corticosteroids ( to reduce
cerebral edema)
Surgical management
 Surgery is needed if:
a. Increased pressure in the brain
continues or gets worse
b. The brain abscess does not get
smaller after medication
c. The brain abscess contains gas
(produced by some types of
bacteria)
d. The brain abscess might rupture.
Craniotomy (opening the
skull, exposing the brain,
and draining the abscess)
Needle aspiration guided by CT or
MRI scan may be needed for a
deep abscess
MRI IMAGE BEFORE & AFTER
NEEDLE ASPIRATION
Complications
Brain damage
Meningitis that is
severe and life
threatening
Recurrence of infection
Seizures
Nursing interventions
 Nursing interventions should
support the medical treatment, as
do patient teaching activities that
address neurosurgical procedures.
 Frequently assess neurologic
status, especially LOC, speech and
sensory, motor and cranial nerve
functions.
Elevate the head of the bed
at 30 degree angle.
Monitor for signs of
increased ICP: decreased
LOC, vomiting, abnormal
pupil response and
depressed respirations.
Patients and families need
to be advised of neurologic
deficits that may remain
after treatment.
Always provide safety
measures.

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Brain abscess