Space-Occupying Lesions - Intracranial Abscesses

Question 1

Aetiology of Brain Abscesses (4).

Answer 1

1. Extension of Sepsis from Middle Ear/Sinuses.
2. Trauma/Surgery to Scalp.
3. Penetrating Head Injuries.
4. Embolic Events e.g. Endocarditis.

Question 2

Clinical Presentation of Brain Abscesses (2).

Answer 2

1. Dependent on site of the Abscess.

2. Considerable Mass Effect - Raised ICP.

Question 3

Clinical Features of Brain Abscesses (4).

Answer 3

1. Dull and Persistent HEADACHE.
2. Fever - can be absent (but no Swinging Pyrexia).
3. Focal Neurology - CNIII, CNIV Palsy (Raised ICP).
4. Other Features of Raised ICP.

Question 4

Investigations of Brain Abscesses.

Answer 4

CT Scanning.

Question 5

Management of Brain Abscesses (3).

Answer 5

1. Craniotomy - Debride Abscess Cavity.
2. IV Antibiotics : 3rd Generation Cephalosporin + Metronidazole.
3. Manage ICP e.g. Dexamethasone.