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BRAIN OR EPIDURAL ABSCESS

General Information

DEFINITION--A collection of pus caused by a bacterial infection in the brain or the outermost of 3 membranes that cover the brain and spinal cord.

BODY PARTS INVOLVED--Brain; meninges (membranes that cover the brain); skull.

SEX OR AGE MOST AFFECTED--

    All ages, but most common in young adults. SIGNS AND SYMPTOMS--The following symptoms usually appear gradually over several hours. They resemble symptoms of a brain tumor or stroke:

  • Pain in the back, if the infection is in the covering of the spinal cord.
  • Headache.
  • Nausea and vomiting.
  • Weakness, numbness, or paralysis of one side of the body.
  • Irregular gait.
  • Convulsions.
  • Fever.
  • Confusion or delirium.
  • Speaking difficulty.

CAUSES--

    The primary source of bacterial infection that causes a brain or epidural abscess often cannot be found. These 3 sources are the most common:

  • An infection that spreads from an infected skull, such as in osteomyelitis, mastoiditis or sinusitis.
  • An infection that is introduced by a skull injury.
  • An infection that spreads through the bloodstream from other infected organs, such as the lungs, skin or heart valves.

RISK INCREASES WITH

  • Head injury.
  • Illness that has lowered resistance, especially diabetes mellitus.
  • Recent infection, especially around the nose, eyes and face.
  • Immunosuppressed patient due to illness (AIDS) or medications.
  • Intravenous drug abuse.

HOW TO PREVENT--Consult your doctor for treatment of any infection in your body--especially one around the nose or face (such as ear infection or dental abscess)--to prevent its spread.


What To Expect

DIAGNOSTIC MEASURES--

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies such as blood studies, spinal-fluid studies, CT scan (See Glossary).
  • X-rays of the skull.

APPROPRIATE HEALTH CARE

  • Intensive care monitoring required.
  • Medical or surgical treatment will depend on location of abscess. Normally requires antibiotic therapy and surgery to drain the abscess. Other treatment may include intravenous fluids and mechanical breathing support.
  • Self-care after returning home.

POSSIBLE COMPLICATIONS

  • Seizures, coma and death without treatment.
  • Permanent brain damage.

PROBABLE OUTCOME--Usually curable with early diagnosis and treatment.


How To Treat

GENERAL MEASURES--

  • The family should maintain an optimistic outlook, stay in close contact with the patient's doctor and help by making their visits with the patient brief and as supportive as possible.
  • Additional information available from the Brain Research Foundation, 208 S. LaSalle Street, Suite 1426, Chicago, IL 60604, (312)782-4311.

MEDICATION--Your doctor may prescribe:

  • Antibiotics for 4 to 6 weeks to fight infection.
  • Anticonvulsants to prevent seizures.

ACTIVITY--While in the hospital, you will need bed rest. After a 2- to 3-week recovery, you should be as active as your strength and feeling of well-being allow.

DIET--While hospitalized, intravenous fluids may be necessary. Following treatment, eat a normal, well-balanced diet.


Call Your Doctor If

  • You have any symptoms of a brain or epidural abscess.
  • Fever rises to 101F (38.3C) or higher.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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