Introduction

Brain Abscess, also known as intracranial abscess, is a collection of infectious material within the tissue
of the brain. Nursing management and intervention of patients with brain abscess is to provide support
to the patient’s medical treatment and teaching the patient and his family on what to do when seizures
attacks.

Definition

A brain abscess is a collection of infectious material within the tissue of the brain.

Bacteria are the most common causative organisms. An abscess can result from intra-cranial surgery,
penetrating head injury, or tongue piercing.

Organisms causing brain abscess may reach the brain by hematologic spread from the lungs, gums,
tongue, or heart, or from a wound or intra-abdominal infection. It can be a complication in patients
whose immune systems have been suppressed through therapy or disease.

Prevention

To prevent brain abscess, otitis media, mastoiditis, rhinosinusitis, dental infections, and systemic
infections should be treated promptly.

Clinical Manifestations

Generally, symptoms result from alterations in intracranial dynamics (edema, brain shift), infection, or
the location of the abscess.

Headache, usually worse in morning, is the most prevailing symptom.

Fever, vomiting, and focal neurologic deficits (weakness and decreasing vision) occur as well.

As the abscess expands, symptoms of increased intracranial pressure (ICP) such as decreasing level of
consciousness and seizures are observed.

Assessment and Diagnostic Methods

History of of infection(s).

Neuroimaging studies such as MRI or CT scanning to identify the size and location of the abscess

Aspiration of the abscess, guided by CT or MRI, to culture and identify the infectious organism

Blood cultures, chest X-ray, electroencephalogram (EEG)

Medical Management

The goal is to eliminate the abscess.

Treatment modalities include antimicrobial therapy, surgical incision, or aspiration (CTguided

stereotactic needle).
Medications used include corticosteroids to reduce the inflammatory cerebral edema and antiseizure
medications for prophylaxis against seizures (phenytoin, phenobarbital).

Abscess resolution is monitored with CT scans.

Nursing Management & Interventions

Nursing interventions should support the medical treatment, as do patient teaching activities that
address neurosurgical procedures.

Patients and families need to be advised of neurologic deficits that may remain after treatment
(hemiparesis, seizures, visual deficits, and cranial nerve palsies).

Frequently assess neurologic status, especially LOC, speech and sensorimotor and cranial nerve
functions.

WOF signs of increased ICP: decreased LOC, vomiting, abnormal pupil response and depressed
respirations.

The nurse assesses the family’s ability to express their distress at the patient’s condition, cope with the
patient’s illness and deficits, and obtain support.

Always provide safety measures.