Brain abscess overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess) or remote (lung, heart, kidney etc.) infectious sources within the brain tissue. The infection may also be introduced through a skull fracture following a head trauma or surgical procedures. Brain abscess is usually associated with congenital heart disease in young children. It may occur at any age but is most frequent in the third decade of life.

Historical Perspective

Prior to the 1800s, brain abscesses were almost uniformly fatal, and were rarely diagnosed prior to autopsy. Macewan was one of the 1st neurosurgeons who showed that these patients could actually be cured via surgical drainage. In the post WWII / antibiotic era, the mortality from brain abscesses really started to drop, and with the advent of the CT in 1974, earlier diagnosis and treatment was finally possible.

Epidemiology and Demographics

There has been a remarkable shift in the epidemiology of brain abscesses over the past several years. Traditionally, and still the case in underdeveloped countries, most brain abscesses are due to un / under-treated otitis and sinusitis. More recently, especially in the U.S., more cases are being seen in immunocompromised patients.

Diagnosis

CT

The diagnosis is established by a computed tomography (CT) (with contrast) examination.