WELCOME

BRAIN ABSCESS
 INTRODUCTION
Brain abscess are the most common
inflammatory condition of the brain and
spinal cord. Inflammation is caused by
bacteria, viruses, fungi and chemicals.cns
infections may occur via the blood stream by
extension from a primary site along cranial
and spinal nerves.
 DEFINITION
• Brain abscess is an accumulation of pus with
in the brain tissues that can result from local
or systemic infections
BRUNNER AND SUDARTH
• Brain abscess is defined as purulence and
inflammation in one or more localized region
with in the brain parenchyma.
 INCIDENCES
• Approximately 8 % of intracranial masses in
developing countries and 1-2% in western
countries.
• Brain abscess are rare in people who are
immuno competent they are more frequently
diagnosed in people who are immuno
supressed as a result of underlying disease
or medications.
• The mortality rate for inflammatory
conditions of the brain is approximatly 10 to
30 % in the general population.
• It is higher in older patients , up to 19% of
these who recover can have long term
neurologic deficits including hearing loss.
 CAUSES AND RISK FACTORS

• Pulmonary infections
• Bacterial endocarditis
• Skull fracture
• Brain trauma
• Brain surgery
• Congenital heart disease
• Cancer and other chronic illness
• Meningitis
• Middle ear infections
• Compromised immune system due to HIV
or AIDS
• Chronic sinus
 PATHOPHYSIOLOGY
• Pathogenic organisms enters into brain
tissue through various routes, ear , throat ,
nose or blood stream

• Collection of infectious material in the brain

tissues

• Increased intra cranial pressure

Due to etiological factors

Infection by the virus and bacteria

enters in to the blood stream

Cross the blood brain barriers

increased intra cranial pressure

creates inflammation in meninges

 CLINICAL FEATURERS
• FRONTAL LOBE
hemiparesis
excessive aphasia
frontal lobe
• TEMPORAL LOBE
localized head ache
changes in vision
facial weakness
• CEREBRAL ABSCESS
occipital head ache
ataxia
nystagmus
• Infection or the location of the abscess
• Head ache
• Fever
• Vomiting
• Focal neurological deficits
• Weakness and decreased vision reflex
• Increased ICP
• Decreased LOC
• Seizures occur
 DIAGNOSTIC FINDINGS
History collection
Physical examination
Neurologic examination
Neuroimaging with CT scan
MRI
Blood culture
Chest X- ray
EEG
 MEDICAL MANAGEMENT
Treatment is aimed at controlling increased
ICP, and draining abscess.
Providing antimicrobial therapy.(directed at
abscess. eg: antibiotics (ceftriaxone,
cefixime, to penetrate BBB and reach abscess.
Corticosteroids – lasix, frusemide (reduce
inflammatory cerebral cerebral edema)
 Anticonvulsant – to treat seizures.
 SURGICAL MANAGEMENT
• NEEDLE ASPIRATION
• DRAIN THE ABSCESS
 NURSES RESPONSIBILITY
The nurse also assess and document the
response to medications
Blood and laboratory test result ,
specifically blood glucose and serum k
levels need to be monitor when steroid
drugs are prescribed.
Electrolyte replacement may be
required to return these values to with
in normal limits.
The nurse must ascess the families
ability to express distress at the patients
condition , cope with the patients illness
and deficits , and obtain support.
 COMPLICATIONS
Subdural emphyema
Osteomyelitis of cranial lobe
Epidural abscess
Venuous sinus thrombosis
Periorbital cellulites
 HEALTH EDUCATION

The brain abscess for the clients health

education should be
Personal hygiene
Liquid and fluid diet
Low fat diet and low carbohydrate diet