A brain abscess is a rare but potentially life-threatening condition, with an incidence of 0.3 to 1.3 cases per 100,000 people. A brain abscess is a collection of pus within brain tissue, usually caused by inflammation or infection. This abscess can occur as a result of a direct infection of the brain due to surgery or injury, or as a result of an infection from other areas such as the sinuses, ear, teeth, or upper respiratory tract. Symptoms associated with a brain abscess include headache, nausea, vomiting, fever, fatigue, and cramps. If an abscess is suspected, home treatment should not be relied upon or delayed, but rather immediate medical intervention is required. For more information about brain abscess, its causes, symptoms, and treatment methods, you can visit the "Dalili Medical" website, where treatment of the infection with antibiotics, removal of pus, and strengthening the immune system are discussed to avoid serious complications. Therefore, it is necessary to consult a doctor immediately if any similar symptoms appear.

**What is a brain abscess?**

 

A brain abscess is a pus-filled sac, sometimes known as a brain abscess, that can cause the brain to swell and put harmful pressure on its tissues. An abscess is the result of a defense mechanism of the immune system aimed at limiting the spread of infection.

**How ​​can I prevent a brain abscess?**

 

If you have an infection elsewhere in the body, it should be treated properly to reduce the risk of a brain abscess.

**What causes a brain abscess?**

 

A brain abscess often occurs when bacteria or fungi enter the brain, either through the bloodstream or from an infected area of ​​the head such as the ears or sinuses. Head injuries or surgeries can also lead to the entry of the germs that cause the abscess.

**When should a brain abscess be removed?**

 

A brain abscess should be removed if any of the symptoms mentioned above appear and do not respond to medical treatment. In this case, the doctor must intervene surgically to avoid serious complications that may lead to the spread of the infection or damage to brain tissue.

**Success Rate of Brain Abscess Surgery**

 

The success rate of brain abscess removal surgery ranges from 80 to 90% thanks to scientific progress and modern techniques in diagnosis and treatment. However, this rate depends on several important factors that the doctor discusses with the patient.

**Factors affecting the success of the surgery**

 

Factors that determine the success rate of the surgery include:

- The patient's age and general health condition.

- The size and location of the abscess and whether it causes serious pressure on the skull.

- The development of accompanying symptoms such as problems with speech, memory, vision, or exposure to coma.

- The period of time between discovering the abscess and starting effective treatment.

- The competence and experience of the treating physician.

**Is brain abscess surgery dangerous?**

 

No, brain abscess surgery is not dangerous and can be treated surgically permanently. However, it is necessary to quickly diagnose and surgically treat any of the symptoms mentioned above.

**Can a brain abscess return after surgery?**

 

Yes, in some rare cases, a brain abscess may return again, and this is considered a possible complication. This condition is more likely to occur in people with a weak immune system or cyanotic heart disease. Therefore, the success rate of brain abscess removal cannot be determined immediately after surgery in these cases, but rather requires long-term treatment until complete recovery.

**Types of abscesses:**

 

- **Abdominal abscess:** is a collection of fluid and pus in the abdominal cavity, and may be close to the liver. The cause of this type is often the rupture of the appendix or ovary, which may lead to the transmission of infection to other organs such as the gallbladder and pancreas.

- **Anal abscess:** occurs as a result of severe blockage in some glands located in the anal opening area, which leads to the accumulation of pus under the skin and severe pain in the rectum and anus.

- **Brain abscess:** It is considered one of the most dangerous types of abscesses, as fluid and pus accumulate inside the meninges. This type may result from infection with some fungi, which leads to the spread of the abscess inside the skull.

**How ​​does infection spread to the brain?**

 

A brain abscess can occur as a result of direct infection or the spread of infection from another part of the body. Infections can reach the brain in three main ways:

1. **Bloodborne infections:** The bloodstream can carry the infection from another part of the body, and these cases account for between 15 and 30 percent of cases. The blood-brain barrier usually prevents the infection from entering, but sometimes the infection can cross this barrier and reach the brain, leading to an infection and abscess.

2. **Common sources of bloodborne infections that cause brain abscesses include:**

- **Cyanotic heart disease:** A heart defect from birth causes low oxygen levels in the blood. 

- **Pneumonia:** Pneumonia and other conditions. 

- **Bronchiectasis:** A permanent widening of the bronchi, which can lead to recurrent respiratory infections. 

- **Peritonitis:** An infection of the layer of cell tissue lining the abdominal wall. 

- **Bladder infections:** And other infections in the pelvic area.

- **Bacterial endocarditis:** An infection of the heart tissue.

Other reported causes of brain abscesses include liver abscess, tongue piercing, and certain gastrointestinal conditions and procedures.

When treating an abscess, it is important to identify the original source of infection, as treating the initial site of infection can help prevent another brain abscess from developing.

**Direct infection**

 

Direct infection occurs when an infection starts in the skull, such as with a nose or ear infection, and then spreads to the central nervous system and from there to the brain.

Examples include:

- Otitis media

- Sinusitis

-Osteomyelitis (infection of the bone behind the ear)

- Osteomyelitis (infection of the bone)

This type of infection accounts for about 25 to 50 percent of brain abscesses.

**Direct trauma**

 

Staphylococcus bacteria can be present in an abscess that forms after a head injury, neurosurgery, or endocarditis.

These conditions can lead to a direct bacterial infection at the site of the abscess, especially after surgery.

If a blow to the head causes a compound skull fracture, bone fragments may be pushed into the brain, forming an abscess.

Penetrating wounds to the head, such as those caused by a bullet or a foreign body, can also be a source of infection, especially if the foreign body is not removed.

A brain abscess can also be the result of a surgical complication, in which cases the cause is relatively easy to determine.

**Causes of brain abscess**

 

There are many causes of brain abscess, including:

- Skull infection

- Middle ear infections

- Sinus infections

- Facial injuries

- Head surgeries

- Foreign body injury that penetrates the skull bones, such as exposure to gunfire or shrapnel

- Dental abscess

- Mastoiditis

- Blood infection or sepsis (generalized)

These cases are caused by:

- Pneumonia

- Lung abscess

- Congenital heart disease in children

- Peritonitis

- Severe bladder infections

**Microbes that cause brain abscess**

 

Staphylococcus and streptococcus are among the most common microbes that cause brain abscess, in addition to fungi, especially in AIDS patients and people with weak immunity.

A brain abscess occurs as a result of infection entering the brain tissue through three main routes:

1. Infection through the bloodstream, often through the nasopharynx

2. Infection from infectious foci in the ear or sinuses

3. Direct infection as a result of head injuries or after head surgery

**Stages of brain abscess**

- **Stage 1:** Early inflammation of the brain tissue

- **Stage 2:** Late inflammation of the brain tissue

- **Stage 3:** Early formation of a capsule or shell of the brain abscess

- **Stage 4:** Late formation of the shell of the brain abscess

**Areas most susceptible to brain abscess**

 

An abscess can form in any area of ​​the brain, but the frontal and temporal lobes are most susceptible. Epidural or subdural abscesses are rare.

**Symptoms of brain abscess**

 

Initially, symptoms of a brain abscess may be vague, appearing as poor concentration. Over time, symptoms may progress to seizures or paralysis.

Symptoms associated with a brain abscess include:

- Headache.

- Fever.

- Seizures.

- Nausea and vomiting.

- Lethargy.

- Changes in mental status, such as confusion, irritability, and nervousness.

- Muscle weakness.

- Speech disturbances.

- Paralysis on one side of the body.

- Vision disturbances, such as blurred or double vision due to pressure from the abscess on the optic nerve.

- Neck stiffness or rigidity.

- Deficiency in the third and sixth cranial nerves.

- Difficulty swallowing.

- Disturbances in consciousness.

**What are the symptoms of a brain abscess?**

 

Here are the most common symptoms of a brain abscess, knowing that each child may have different symptoms. Symptoms include:

**In infants and young children:**

 

- Fever.

- Swollen fontanelle (the soft spot on the top of the head).

- Drowsiness or decreased alertness.

- Increased irritability.

- Loud screams.

- Poor feeding.

- Frequent vomiting.

- Seizures.

**In older children:**

 

- Fever.

- Complaints of severe headache.

- Nausea and vomiting.

- Changes in personality or behavior.

- Changes in speech.

- Trouble walking.

- Increased movement of the arms or legs (spasticity).

- Seizures.

The symptoms of a brain abscess are similar to other medical conditions, so it is always advisable to consult a doctor to diagnose your child's condition.

**Complications of a brain abscess**

 

A brain abscess is a serious medical condition that can lead to death if not treated appropriately. Possible complications include:

- Meningitis.

- Increased intracranial pressure.

- Septicemia.

- Brain herniation.

- Recurrent seizures.

- Neurological impairment.

- Blood clots.

- Brain tissue damage due to pressure from the abscess or insufficient blood supply in some cases.

**When do brain infections turn into abscesses?**

 

Brain infections turn into abscesses when the bacteria causing the infection reach the brain tissue, either through the bloodstream or from a source of infection close to the head (such as an infection in another area of ​​the body). These bacteria penetrate the blood-brain barrier, leading to inflammation of the brain tissue, which stimulates an immune system response, where immune cells and white blood cells come out to attack the bacteria.

As a result, pus or pus forms, which consists of dead bacteria, immune cells, and dead cells from the brain tissue. The pus is surrounded by a cyst or capsule to isolate it from healthy tissue, which leads to the formation of what is known as a brain abscess.

**How ​​is a brain abscess diagnosed?**

 

A brain abscess is usually diagnosed through a set of clinical and imaging tests, including the following steps:

1. **Patient examination:** The doctor evaluates the symptoms, the patient's medical history, and possible sources of infection.

2. **Neurologic Examination:** A neurologic examination is performed to assess the condition of the brain and nervous system, including movement, reflexes, sensory perception, and coordination.

3. **Blood Tests:** Blood tests are performed to measure signs of infection in the body (such as white blood cell count) and to assess the presence and severity of infection.

4. **Imaging Tests:** Imaging techniques such as computed tomography (CT) and ultrasound are used toMagnetic resonance imaging (MRI) to determine the location and size of the abscess, as well as to detect any damage or inflammation in the brain tissue.

5. **Biopsy:** In rare cases, a biopsy may be required to confirm the presence of a brain abscess, where a sample of the affected tissue is taken and examined in the laboratory.

The diagnosis of a brain abscess depends on clinical findings, imaging examinations, and laboratory tests, which help in accurately assessing the patient's condition and determining the appropriate treatment.

**Brain abscess treatment**

 

**Antibiotic treatment:** Since a brain abscess is often the result of a bacterial infection, the use of antibiotics is the first choice of treatment.

**Surgical intervention:** In some cases, it may be necessary to drain or surgically remove the abscess. This allows the fluid collected in the abscess to drain and helps control the infection.

**Symptom treatment:** Medications can be used to relieve symptoms such as headache, fever, and others.

**Seizure medications:** A brain abscess may cause seizures or worsen existing seizures. In this case, anticonvulsant medications may be prescribed to control seizures.

**Close monitoring:** During the treatment period, the patient's condition is closely monitored. Blood tests and imaging tests are performed periodically to assess the effectiveness of the treatment and ensure that the infection subsides.

**Treatment of brain abscess with medications**

 

Medicinal therapy usually begins before diagnosis to avoid complications, and in some cases, treatment may be limited to medications due to the risks of surgery.

**Cases of resorting to drug therapy without surgery:**

 

- The presence of multiple abscesses.

- Small abscess size (less than 2 cm).

- The presence of an abscess deep inside the brain.

- Meningitis.

- Hydrocephalus (fluid accumulation in the brain).

Antibiotics or antifungal medications are usually given intravenously, as the doctor seeks to treat the abscess and the original infection that caused it.
**Abscess removal and drainage surgery**

 

In many cases, surgical intervention is required if the brain abscess is larger than 2 cm.

**Surgical intervention methods for abscess removal:**

 

1. **Simple abscess aspiration:** Dr. Ahmed El-Gheity, a consultant neurosurgeon, accurately locates the abscess using CT scans. After careful planning, a fine needle is inserted through the skull bone under local anesthesia, where the abscess is aspirated and the surrounding area is cleaned.

2. **Open abscess removal:** This method is more invasive, but sometimes necessary. Open surgery (craniotomy) requires the temporary removal of a small portion of the skull bone to reach the abscess. The surgeon benefits from the guidance of the CT scan, and the operation takes about 3 hours under general anesthesia.

3. **Stereotaxic brain abscess drainage:** Surgical procedures are performed in the deep parts of the brain using a stereotaxic positioning device, which allows precise access without damaging healthy tissue. The device's system is turned on after taking accurate images of the brain and determining the coordinates of the abscess, then the biopsy needle is carefully inserted to drain the abscess and clean its location.

**The advantages of this method include:**

 

- Reducing the possibility of error in removing the abscess.

- Providing the shortest path to reach the abscess while preserving healthy tissue as much as possible.

**Treatment of abscesses with herbs**

 

**Tea tree oil:** This oil is characterized by its ability to combat various types of harmful bacteria. However, it should be avoided to apply it directly to the skin because it may cause a burning sensation. It is preferable to dilute it by adding another oil, then put a few drops of it on a piece of cloth and apply it to the affected area twice a day.

**Turmeric:** Turmeric contains a percentage of curcumin, which helps fight inflammation, in addition to a group of substances that contribute to purifying the blood from toxins. You can boil a spoonful of turmeric powder in a cup of milk or water and drink it three times a day. It can also be used topically by mixing it with ginger and water until a cohesive paste is obtained, then applied to the abscess twice a day.

**Garlic and onions:** You can crush some garlic cloves or pieces of onion and put them on a piece of cloth, then apply it to the abscess for up to 10 minutes twice a day.

**Ginger:** Ginger is considered one of the effective medicinal herbs in eliminating bacteria and skin pimples, and has a positive effect in treating abscesses.

**Tomatoes:** It is recommended to prepare a thick paste of tomatoes and place it directly on the abscess, as this recipe is effective and quick in getting rid of different types of abscesses that cause severe pain in the affected area.