Understanding and Managing Brain Abscess

University:
Northwest College
Course:
VN 220 | Medical/ Surgical
Academic year:

2023
Views:

168

Pages:

2
Author:

Yesenia M.

BRAIN ABSCESS Is a collection of infectious material within the tissue in the brain They are rare in people who are immunocompetent, and are more freq diagnosed in people who are immunosuppressed as a result of an underlying disease of the use of immunosuppressive medications. Mostly caused by BACTERIA Most common predisposing conditions for abscesses among adults who are immunocompetent are otitis media and rhinosinusitis . Can result from intracranial sx Penetrating head injury Tounge piercing -organisms that cause brain abscesses may reach the brain by hematologic spread from the lungs, gums, tounge, heart, or from a wound or intra abdominal infection. CLINICAL MANIFESTATIONS Result from intracranial dynamics (edema, brain shift ) , infection or the location of the abscess HEADACHE is usually the most prevalent symptom – worse in MORNING Mental status changes Fever Vomiting Focal deficits- weakness , decreasing vision As abscess expands, s/s of increased ICP result (decreasing LOC and seizures) FRONTAL LOBE ABSCESS -expressive aphasia -frontal HA -hemiparesis -seizures TEMPORAL LOBE -changes in vision -facial weakness -localized HA -receptive aphasia CEREBRELLAR ABSCESS -ataxia -nystagmus -occipital HA ASSESSMENT AND DX FINDING: Neuroimaging w CT scanning w contrast – used to identify the size and location of the abscess Aspiration of the abscess by guided CT or MRI- used to culture and identify the infectious organism Blood cultures- obtained if the abscess is believed to arise from a distant source. MEDICAL MANAGEMENT: Large IV doses given to penetrate the BBB and reach the abscess. Initial atb started is ceftriaxone combined w metronidazole (but its based off culture C&S results) Surgical excision is not the preferred method unless the abscess is large and multi-lobated. Corticosteroids- to help reduce inflammatory cerebral edema if the pt shows evidence of an increasing neurologic deficit Anticonvulsants- to prevent or tx seizures