Brain Abscess

What are the symptoms of a brain abscess?

Symptoms vary from child to child, based on their age. The most common include:

For babies and younger children:

• fever
• a full or bulging soft spot on the top of the head
• sleepiness or less alert than usual
• increased irritability
• high-pitched cry
• poor feeding
• projectile vomiting
• seizures

For older children:

• fever
• complaints of severe headaches
• nausea and vomiting
• changes in personality or behavior
• changes in speech
• problems walking
• increased movement in the arms or legs (spasticity)
• seizures

What causes a brain abscess?

The most common causes are viruses and bacteria. Several factors may increase your child's chances of developing a brain abscess:

• congenital (present at birth) heart disease
• meningitis
• chronic middle ear and sinus infections
• dental or jaw infections
• infections of the face or scalp
• head injury or skull fracture
• traction (a device placed around the head to hold the head and neck areas still; used in patients with broken necks)
• shunt (devices used to drain excess amounts of cerebral spinal fluid)

How do we diagnose a brain abscess?

During the physical examination, your child's doctor will obtain a complete medical history of your child. In addition to urine and stool tests and a measure of your head's circumference, a doctor may do any of these diagnostic tests:

• x-ray
  • uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• magnetic resonance imaging
  • also called an MRI
  • uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body
  • Intravenous (IV) contrast agents may be given during the scan to better see the abscess
• computerized tomography scan
  • also called a CT or CAT scan
  • uses a combination of x-rays and computer technology to shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
• sputum culture
  • tests the stuff coughed up from the lungs and into the mouth
  • helps to see if an infection is present
• lumbar puncture
  • also called a spinal tap
  • a special needle is placed into the lower back, into the spinal canal
  • measures the pressure in the spinal canal and brain
  • a small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems
• electroencephalogram
  • also called an EEG
  • records the brain's continuous, electrical activity by means of electrodes attached to your scalp
• intracranial pressure monitoring
  • also called ICP
  • measures the pressure inside of your head

How do we treat a brain abscess?

The key to treating a brain abscess is early detection and treatment. A child with a brain abscess requires immediate hospitalization, treatment, and close monitoring. After your child is hospitalized, our team of doctors and nurses will educate your family on how to best care for your child at home.

Traditional treatments for a brain abscess

The goal of treatment is to reduce the pressure in your child's head and to treat the infection.

• medications: used to control the infection, seizures, fever, and/or other conditions that may be present
• surgery: required if the medication doesn't work, the abscess gets bigger, or there is a chance of the abscess rupturing
• breathing machine: used in severe cases to help your child breathe easier
• therapy: physical, occupational, or speech therapy to help your child regain muscle strength and/or speech skills