Brain Abscess

Brain Abscess

A brain abscess or cerebral abscess is a buildup of pus in the brain due to infection . A brain abscess is often caused by a bacterial or fungal infection in the brain triggered by a head injury , or an infection in another area of ​​the body that spreads to the brain.

Brain abscess  is often characterized by the appearance of severe headaches, fever, seizures, and even impaired consciousness. This condition is dangerous because it can cause swelling of the brain that requires prompt and appropriate treatment.

Causes of Brain Abscess

The main cause of a brain abscess is a bacterial or fungal infection of the brain tissue. The infection can come from an infection in the brain, a head injury, a surgical procedure in the brain, or the spread of infection from other organs.

The type of bacteria that most often causes the accumulation of pus in the brain comes from the  Bacteriodes , Streptococcus , Staphylococcus , or  Enterobacter groups . While other types of pathogens that most often cause the formation of brain abscess are the fungus  Aspergillus   or the parasite  Toxoplasma gondii .

There are several factors that can increase the risk of brain abscess, namely:

  • Have a weak immune system, for example due to suffering from HIV/AIDS , cancer, or using  immunosuppressant drugs
  • Have a middle ear infection ( otitis media ), infection of the ear bones ( mastoiditis ),  sinusitis , tooth abscess, or  meningitis
  • Have  had a head injury , skull fracture, or have had surgery on the head or neck
  • Suffering from lung infection,  endocarditis , infection in the abdominal cavity, pelvic infection, or  skin infection
  • Suffering  from congenital heart disease  (CHD) or abnormalities in the pulmonary blood vessels or  pulmonary arteriovenous fistula

Symptoms of Brain Abscess

Symptoms of a brain abscess can vary, depending on the size and location  of the abscess . Symptoms that appear can develop slowly or quickly.

Here are some of the symptoms of a brain abscess:

  •  Constant headache
  • Stiff neck or back
  • Nausea and vomiting
  • High fever
  • Shivering
  • Seizure
  • Impaired nerve function, such as muscle weakness, paralysis, or slurred speech
  • Changes in behavior, such as restlessness or confusion
  • Visual disturbances, such as double, blurred, or blurry vision

When to go to the doctor

See a doctor immediately  if you experience any of the symptoms listed above, especially if you have a severe headache accompanied by a high fever, seizures, muscle paralysis, and difficulty speaking. Brain abscess must be treated quickly and appropriately to prevent life-threatening complications of the sufferer.

If you have a disease that can increase your risk of developing a brain abscess, such as sinusitis, meningitis, otitis media , or a heart infection, follow the treatment given by your doctor until complete.

Brain Abscess Diagnosis

To diagnose a brain abscess, the doctor will ask questions about the symptoms, as well as the patient's medical history and health. Next, the doctor will perform a thorough physical examination, including a neurological examination (neurology).

The doctor will also perform investigations to confirm the diagnosis and determine the cause of the brain abscess. Some of the checks that will be carried out are:

  • Blood tests , to detect signs of infection from the level and number of blood cells
  • Scans with X-rays, CT scans, or  MRIs , to determine the location and size of the brain abscess
  • Biopsy , to identify changes in cells and tissues in the brain, as well as to determine the pathogens that cause brain abscess
  • Lumbar puncture , to identify pathogens, including the type of bacteria that causes brain abscess
  • Blood culture , to find out the bacteria or fungus that causes brain abscess
  • Record brain waves or electroencephalogram ( EEG  ), to determine electrical activity in the brain, especially in brain abscess patients who experience repeated seizures

If a brain abscess is suspected from an infection in another part of the body, such as the respiratory tract, a sputum culture  can be done to determine the type of germ that infects the lungs.

Brain Abscess Treatment

Brain abscesses need to be treated as soon as possible. The method of treatment depends on the size, number, and type of bacteria or germs causing the abscess in the brain.

Treatment of brain abscess also aims to relieve complaints and prevent complications. Some of the treatment methods that doctors can do are:


Medications are given to treat infections and reduce complaints experienced by patients. Some types of drugs that can be given are:

  • Antibiotics or antifungals, to treat infections, including to treat brain abscesses caused by toxoplasmosis
  • Diuretics and corticosteroids, to reduce pressure and swelling in the brain
  • Anti-seizure drugs, to treat seizures that can occur in brain abscess


Surgery will be performed if the abscess is larger than 2 cm or if the abscess is at risk of rupturing and damaging the surrounding brain tissue. The goal of surgery is to remove the abscess.

There are two types of surgery that can be done to treat a brain abscess, namely:

Simple aspiration

Simple aspiration  aims to remove the accumulated pus. This action can be done with the help of a CT scan to confirm the point of the abscess.


In a craniotomy , the doctor will remove a small part of the skull bone ( a flap ) in order to access the infected brain tissue, then remove the abscess from the brain tissue.

After surgery, the patient must be hospitalized for some time so that his condition can continue to be monitored.

Complications of Brain Abscess

A brain abscess has the potential to cause the following complications:

  • Abscess comes back
  • Brain tissue damage
  • Epilepsy
  • Meningitis
  • Sinusitis
  • Infection of the bone behind the ear ( mastoiditis )
  • Brain swelling
  • Sepsis
  • Come
  • Dead

Brain Abscess Prevention

The way to prevent a brain abscess is to avoid the cause. Some of the ways that can be done are:

  • Undergo examination and treatment to completion if suffering from an infectious disease
  • Maintain dental and oral health and hygiene, including regular check-ups with the dentist
  • Using protective equipment, such as helmets, when working in an environment where there is a risk of head injury
  • Implementing healthy sexual behavior to avoid transmission of HIV/AIDS
  • Living a healthy lifestyle, such as quitting smoking, eating a healthy and balanced diet , and exercising regularly
  • Don't take drugs carelessly
  • Get vaccinated to prevent certain bacterial infections, such as meningitis , pneumonia, and Hib
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