The typical symptoms of brain abscess include slowly progressive headache with an alteration in level of consciousness and neurological deficits. This case illustrates that some patients, however, present with acute stroke-like symptomatology.
Left untreated, a brain abscess may lead to neurological damage, and ultimately death. The overall mortality rate from a brain abscess is 10 percent, but if the abscess ruptures into the ventricle (the fluid chambers in the brain), the mortality rate goes up to as much as 25 to 40 percent.
A brain abscess is regarded as a medical emergency. Swelling caused by the abscess can disrupt the blood and oxygen supply to the brain. There's also a risk of the abscess bursting (rupturing). If left untreated, a brain abscess can cause permanent brain damage and could be fatal.
However, there have been reports of brain abscess as complication of stroke in adults. To date, there are 20 case reports of brain abscess after stroke that were published [38-57]. All of these are reported in adults. The abscess is reported to develop 12 days to 14 months after the stroke incident [58,59].
A brain abscess can grow very quickly, typically becoming fully formed within about two weeks. Your doctor will begin treatment immediately after you are diagnosed. Prompt medical attention is the key to relieving your symptoms more quickly and minimizing damage to your long-term health.
You'll also receive a number of CT scans, to make sure the brain abscess has been completely removed. Most people need a further 6 to 12 weeks rest at home before they're fit enough to return to work or full-time education.
Pathogenesis. Brain abscess development can be divided into four stages: 1) early cerebritis (1–4 days); 2) late cerebritis (4–10 days); 3) early capsule formation (11–14 days); and 4) late capsule formation (>14 days). Staging of brain abscess in humans has been based on findings obtained during CT or MRI scans.
Brain abscess passes through 4 stages: early cerebritis, late cerebritis, early capsule, and late capsule. During early cerebritis, nonenhanced CT scans may demonstrate normal findings or may show only poorly marginated subcortical hypodense areas.
The most common symptoms are a headache and fever, and some people may also have nausea and/or vomiting. Because these can be symptoms of many illnesses, a brain abscess can be hard to detect at first. In two-thirds of cases, people have symptoms for as long as two weeks before they are diagnosed.
pulmonary arteriovenous fistula – a rare condition in which abnormal connections develop between blood vessels inside the lungs; this can allow bacteria to get into the blood and, eventually, the brain. a dental abscess or treatment for tooth decay.
Between 1,500 and 2,500 cases occur each year in the United States. Brain abscesses are most likely to affect adult men aged under 30 years. Among children, they most commonly develop in those aged 4–7 years.
Intracranial abscesses are uncommon, serious, life-threatening infections. They include brain abscess and subdural or extradural empyema and are classified according to the anatomical location or the etiologic agent. The term brain abscess is used in this article to represent all types of intracranial abscesses.
Long-term neurological sequelae were analyzed in 40 patients who survived a brain abscess with surgery. These survivors included 24 adults and 16 children. The median follow-up interval was 72 months. The most common deficits observed were hemiparesis, seizures, visual field defects, and learning problems in children.
Most patients with brain abscess require surgical drainage, in addition to antibiotics, for both diagnostic and therapeutic purposes.
Antibiotics are the first-line treatment for brain abscess. High-dose, broad-spectrum, intravenous antibiotics should be administered as early as possible in the patient's course. Emergent consultation with neurosurgery is recommended; however, delay in consultation should not delay antibiotic administration.
The risk of a brain abscess is a complication of odontogenic infection that is rarely considered by physicians and little spoken of, yet treating dental infections may avoid a potentially life-threatening condition. We report a case of 7-year-old boy with a brain abscess secondary to a dental infection.
The CT in our second case shows low attenuation with mass effect in the right thalamus. The contrast-enhanced CT scan in the patient demonstrated rim enhancement of the mass. This finding can be seen with primary tumors, metastatic tumors, and brain abscesses.
For instance, diffusion-weighted (DWI) MRI has been suggested to differentiate brain abscess from primary, cystic, or necrotic tumors (20), based on the limited free motion of water molecules in the viscous milieu in the necrotic center of abscess cavity.
Once an abscess has formed, surgical excision or drainage combined with prolonged antibiotics (usually 4-8 wk) remains the treatment of choice.
The wound may drain for the first 2 days. Cover the wound with a clean dry dressing. Change the dressing if it becomes soaked with blood or pus. If a gauze packing was placed inside the abscess pocket, you may be told to remove it yourself.
Encephalitis Prognosis
In general, the brain doesn't bounce back as quickly as other body parts such as bone, skin and muscles, but it does have some capacity to recover. Mild cases of encephalitis are usually short and result in a full recovery.