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BRAIN ABSCESS

BRAIN ABSCESS

• A collection of infectious material within the tissue of the brain

Causative Organism: Bacteria
Predisposing Conditions:
• Immunocompetent: otitis media & rhinosinusitis
• Intracranial surgery
• Penetrating head injury
• Tongue piercing
• Immunocompromised condition
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BRAIN ABSCESS

CLINICAL MANIFESTATIONS
Frontal Lobe
• Hemiparesis
• Aphasia (expressive)
• Seizures
• Frontal headache
Temporal Lobe
• Localized headache
• Changes in vision
• Facial weakness
• Aphasia
Cerebral Abscess
• Occipital headache
• Ataxia
• Nystagmus (rhythmic, involuntary movements of the eyes)
✓ Headache (worse in the morning)
✓ Fever, vomiting & focal neurologic deficits (weakness &
decreasing vision)
✓ Later: S/s of increased ICP ( decreasing LOC & seizures)

ASSESSMENT AND DIAGNOSTIC FINDINGS

1. MRI and CT Scan – to identify the size and location of the abscess
- reveal a ring a round a hypodense area
2. Aspiration of the abscess (guided by MRI or CT scan)
- best method to culture and identify the infectious organism
3. Blood Cultures – if abscess is believed to arise from a distant source
4. Chest X-Ray – to rule out predisposing lung infections
5. EEG – helps localize the lesion
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BRAIN ABSCESS

MEDICAL MANAGEMENT
Goals:
1. Control increased ICP
2. Drain the abscess
3. Provide antimicrobial therapy
PHARMACOLOGIC MANAGEMENT
1. Large IV doses of antibiotics to penetrate the BBB and reach the abscess
2. Stereotactic CT-guided aspiration – to drain the abscess and identify the
causative organism
3. Corticosteroids – to help reduce the inflammatory cerebral edema
4. Anti-seizure medications

NURSING MANAGEMENT
Focuses:
• Continuing to assess neurologic status
• Administering medications
• Assessing the response to treatment
• Providing supportive care
1. Neurologic assessment – note changes in ICP
2. Document responses to medications
3. Monitor blood laboratory test results
- blood glucose and serum K+ (corticosteroid therapy)
➔ insulin or electrolyte replacement
4. Ensure safety
weakness/ seizures ➔ injuries
5. Assess family’s ability to express distress at the patient’s condition
(hemiparesis, seizures, visual deficits, cranial nerve palsies)