Brain abscess

Description:

Focal accumulation of pus in brain substance.

Abscesses of a brain are always secondary. Most often the disease is caused staphylococcus, by streptococci, mushrooms, colibacilli, anaerobic bacteria. There are two mechanisms of spread of an infection: contact and hematogenous. The mechanism of contact distribution is that abscess of a brain can arise as a result of otitises and mastoidites, and accumulation of pus is localized in a temporal share and a cerebellum (otogenic abscesses). The mechanism of hematogenous distribution consists in developing of abscess as a result of bacteremia during pneumonia or an infectious endocarditis (metastatic abscesses). At abscesses of this kind the source of bacteremia does not manage to be found in 1/5 cases.

It is necessary to diagnose this disease according to the anamnesis, to existence of symptoms of a disease and the progressing current. Choice methods for tool diagnosis of abscess of a brain are a computer and magnetic and resonant tomography. At impossibility of carrying out these researches, appoint an ekhoentsefaloskopiya which allows to reveal the possible shift of median structures of a brain, and also a kraniografiya by means of which definition of symptoms of intracranial hypertensia is possible. Carrying out a lumbar puncture is possible, but at a severe disease at the patient this technique of diagnosis can lead even to a lethal outcome.

The differential diagnosis follows with a brain tumor, a stroke, encephalitis.

Brain Abscess symptoms:

The clinical picture is characterized by all-brain and focal signs, and in an acute stage - all-infectious. The onset of the illness usually is followed by high temperature, a leukocytosis, headaches, vomiting, bradycardia, an oglushennost. Focal symptoms depend on localization of abscess. At otogenic abscess the center is localized most often in temporal area or in a cerebellum. At seldom found rhinogenic abscesses pus from adnexal bosoms spreads in frontal lobes of a brain.

It is not necessary to lose sight that sometimes abscess is localized not on the party of otitis, and on opposite. The meningeal phenomena are noted at proximity of process to covers. Cerebrospinal fluid in an acute stage is vospalitelno changed, and in chronic - is more often normal. Quite often after an acute meningoentsefalitichesky stage remission which is replaced by a phase of increase of focal and all-brain symptomatology, as follows at a brain tumor. Disease duration sometimes reaches several years.

The most dangerous complication is the break of abscess in a subarachnoid space and ventricles that can take place in any stage of a disease.

The diagnosis of abscess of a brain is based on data of the anamnesis (the acute beginning, high temperature, existence of otitis, bronchiectasias and other centers of a purulent infection), clinic and contrast methods of a research.

Brain Abscess reasons:

Classification:
rhinogenic abscesses of a brain (owing to purulent rhinitises, sinusitis)
otogenic abscesses of a brain (owing to purulent otitises, labyrinthites, eustachites, mastoidites)
abscesses as a result of a craniocereberal injury
metastatic abscesses as a result of purulent defeats of other bodies preferential easy.

Treatment of Abscess of a brain:

Drug treatment using various antibiotics, vitamins and nootropic means and neurosurgical, consisting at a distance abscess. The forecast is favorable. The lethality of an outcome is lower than 10%.
Patients with abscess of a brain are placed in a hospital, appoint by it antibiotics and streptocides. After establishment of localization surgical treatment is carried out. The best, but not always the feasible method is offered N. N. Burdenko: removal of abscess together with the capsule. Spasokukotsky's method - Bakuleva consists in repeated punctures with suction of pus and introduction to an abscess cavity of antibiotics and disinfecting substances. The oldest is the method of broad opening and the subsequent drainage of abscess. All operative measures are carried out against the background of therapy by antibiotics and streptocides. Intrakarotidny administration of penicillin (50000 ides) practices; at increase intracranial davleniya-degidra-. tatsionny therapy (glucose, sulfate magnesia, etc.). Treatment of complications of abscess of a brain conservative. The forecast adverse at metastatic, multiple abscesses of a brain. At single abscesses after operation recovery occurs in 70-80% of cases. Prevention consists in sanitation of the centers of a purulent infection in an organism, especially in the head, timely processing of the getting skull wounds.