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.