Neurology

Brain abscess

A brain abscess is a focal intracranial collection of infected material that combines a deep infection with an expanding mass, requiring urgent neurosurgical, infectious-disease and source-control management.

Definition

A brain abscess is a focal collection of infected material within the brain parenchyma, usually encapsulated and surrounded by oedema. It is both a deep intracranial infection and a space-occupying lesion.

First principles

The route of spread predicts the search for the source

Infection can spread contiguously from the ear, mastoid, sinuses or teeth; haematogenously from a distant focus such as endocarditis, pneumonia or a right-to-left shunt; or directly after trauma or neurosurgery. Multiple lesions or a grey-white-junction distribution suggest bloodstream seeding, but imaging and microbiology must guide the search.

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