Brain Abscess

Question 1

Causes of brain abscess

Answer 1

• extension of sepsis from middle ear/ sinuses
• trauma or surgery to the scalp
• penetrating head injuries
• embolic from endocarditis

Question 2

Clinical features

Answer 2

• dull/persistent headache
• fever
• focal neurology (CN III/VI palsies common in raised ICP)
• nausea
• papilloedema
• seizures

Question 3

What cranial nerve palsies usually occur in patients with raised intracranial pressure?

Answer 3

CN III - oculomotor
CN VI - abducens

Question 4

Diagnostic investigation

Answer 4

CT scan

Question 5

Management of brain abscess

Answer 5

• surgery
  => craniotomy + abscess cavity debrided

IV antibiotics:
cephalosporin + metronidazole

IV dexamethasone for ICP