Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material, coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess) or remote (lung, heart, kidney, etc.) infectious sources, within the brain tissue. The infection may also be introduced through a skull fracture following head trauma or surgical procedures. Brain abscess is usually associated with congenital heart disease in young children. It may occur at any age but is most frequent in the third decade of life. Although brain abscess is relatively rare, it is a complication encountered increasingly in patients whose immune systems have been suppressed either through therapy or disease.
What is the Pathophysiology of Brain Abscess?
A brain abscess could be a collection of irresistible fabric inside the tissue of the brain. It may happen by the coordinate attack of the brain from intracranial injury or surgery; by the spread of infection from nearby destinations, such as the sinuses, ears, and teeth (paranasal sinus infections, otitis media, dental sepsis); or by the spread of infection from other organs (lung abscess, infective endocarditis) (Hickey, 2003). To anticipate brain abscess, otitis media, mastoiditis, sinusitis, dental contaminations, and systemic diseases ought to be treated promptly.
What are the Signs and Symptoms or Clinical Manifestations of Brain Abscess?
The clinical signs of a brain abscess result from modifications in intracranial flow (edema, brain move), contamination, or the area of the abscess. Cerebral pain, ordinarily worse in the morning, is the foremost winning side effect. Vomiting is also common. Focal neurologic signs (weakness of an extremity, diminishing vision, seizures) may happen, depending on the location of the abscess. There may be a alter in mental status, as reflected in lethargic, befuddled, crabby, or muddled behavior. Fever may or may not be displayed.
Symptoms of Brain Abscess:-
- Aphasia ( Expressive ).
- Frontal Headache.
- Localized Headache.
- Change in vision.
- Facial weakness.
- Occipital Headache.
- Ataxia (inability to coordinate movements).
- Nystagmus (Rhythmic, involuntary movements of the eye).
What is the Diagnostic Evaluation of Brain Abscess?
In the condition of brain abscess Repeated neurologic examinations and proceeding evaluation of the patient is essential to decide the area of the abscess. A computed tomography (CT) check is important in finding the site of the boil, After the advancement and determination of suppurative lesions, and in deciding the ideal time for surgical mediation. A magnetic resonance imaging (MRI) scan is valuable to obtain pictures of the brain stem and posterior fossa in the event that an abscess is suspected in these regions.
Explain the Management of Brain Abscess?
Brain Abscess Medical Management:-
Brain sore is treated with antimicrobial therapy and surgical incision or aspiration. On the off chance that the abscess is encapsulated, CT-guided stereotactic needle aspiration beneath local anesthesia may be performed. Antimicrobial treatment is prescribed to dispense with the causative organism or decrease its virulence. Penicillin G (20 million U) and chloramphenicol (Chloromycetin) (4 to 6 g/day given intravenously in separated measurements) are usually prescribed because anaerobic streptococci and Bacteroides are the foremost common causative organisms (Hickey, 2003). Large IV doses are usually prescribed preoperatively to enter the blood-brain boundary and reach the abscess. The treatment proceeds postoperatively. Corticosteroids may be endorsed to help reduce the inflammatory cerebral edema in the event that the patient shows evidence of an expanding neurologic deficit. Antiseizure medicines (phenytoin, phenobarbital) may be endorsed to prevent seizures. Numerous abscesses may be treated with suitable antimicrobial therapy alone, with close monitoring by CT scans.
Brain Abscess Nursing Management:-
Nursing care focuses on ongoing assessment of the neurologic status, administering medications, assessing the response to treatment, and providing supportive care.
Continuous neurologic evaluation alerts the nurse to changes in ICP, which may show a requirement for more aggressive intervention. The nurse also assesses and records the reactions to drugs. Blood laboratory test results, particularly blood glucose and serum potassium levels, ought to be closely checked when corticosteroids are endorsed. Medical intervention may be required to return these values to typical or satisfactory levels.
Patient security is additionally a key nursing responsibility. Damage may result from a decreased level of awareness and falls related to motor weakness or seizures.
The patient with a brain abscess is greatly sick, and neurologic deficits may stay after treatment, such as hemiparesis, seizures, visual deficits, and cranial nerve palsies. Focal seizures are the foremost common sequelae, happening in almost 30% of patients (Hickey, 2003). The nurse must assess the family’s ability to express their trouble at the patient’s condition, adapt to the patient’s illness and deficits, and get support.
- Brunner and Suddarth’s, Textbook of Medical-Surgical Nursing, 10th edition, Management of Patients With Neurologic Infections, Autoimmune Disorders, and Neuropathies.