Brain abscess

Contents


What is the most frequent intracranial locations for Brain abscess?

  1. frontal-temporal,
  2. frontal-parietal,
  3. parietal,
  4. cerebellar,
  5. occipital lobes

What is the most frequent microbial pathogens that cause brain abscesses ?

  1. Staphylococcus and Streptococcus.
  2. Among this class of bacteria, Staphylococcus aureus and Viridian streptococci are the commonest.

What is the Triad of Brain Abscess?

  1. fever,
  2. headache
  3. focal neurologic deficit

What is the most common medical symptom of Brain Abscess?

Headache – 69% to 70%

Mental status changes -65%

Focal neurologic deficits – 50% to 65%

Fever – 45% to 53%

Seizures -25% to 35%

Nuchal rigidity – 15%


Which seizures are most common in frontal abscesses?

Grand mal seizures – commonest in frontal abscesses.


Which brain abscess is associated with Nuchal rigidity?

Most commonly associated with occipital lobe abscess or an abscess that has leaked into a lateral ventricle.


What is cryptogenic brain abscess?

  1. Source of the infection is unknown
  2. 15% cases constitute – cryptogenic brain abscess

Which cranial nerve affected in brain abscess?

Third and sixth cranial nerve


What is Meningism ?

Meningism is the clinical syndrome of –

  1. headache
  2. neck stiffness
  3. photophobia
  4. nausea and vomiting.

Rupture of abscess usually presented with suddenly worsening headache and followed by emerging signs of meningismus.


Which vascular territory is most commonly involved in brain abscess in cases of hematogenous spread from a distant focus?

Most frequently found in the distribution of the middle cerebral artery

Usually – multiple and multiloculated abscess are seen


Which is the most commonly effected lobe in brain abscess due to hematogenous spread from a distant focus?

Descending frequency

  1. Frontal lobe -Commonest
  2. Temporal,
  3. Parietal,
  4. Cerebellar,
  5. Occipital

What % of patients with brain abscess have Papilledema ?

Papilledema – 25% of cases of brain abscess have


Apatient is on work up for brain abscess. Now he shows suddenly worsening headache, followed by emerging signs of meningismus. What is the most probable cause?

Rupture of the abscess


A patient of brain abscess shows the clinical features of Nystagmus, ataxia, vomiting, and dysmetria. Where is the most probable location of brain abscess?

Cerebellar abscess


A patient of brain abscess shows the clinical features of Facial weakness, headache, fever, vomiting, dysphagia, and hemiparesis. Where is the most probable location of brain abscess?

Brainstem abscess


A patient of brain abscess shows the clinical features of Headache, inattention, drowsiness, mental status deterioration, motor speech disorder, hemiparesis with unilateral motor signs, and grand mal seizures. Where is the most probable location of brain abscess?

Frontal abscess


A patient of brain abscess shows the clinical features of Headache, ipsilateral aphasia and visual defects. Where is the most probable location of brain abscess?

Temporal lobe abscess


Brain abscess with presentation of neck rigidity suggest which location of the lesion?

Occipital abscess – Neck rigidity suggests Occipital abscess


Commonest organism associated with brain abscess due to Solid organ transplantation?

Solid organ transplantation leads to an increased incidence in fungal brain abscess mostly related to Aspergillus


What is the Cerebrospinal fluid (CSF) analysis picture in Brain abscess?

Cerebrospinal fluid (CSF) analysis may reveal –

  1. pleocytosis,
  2. elevated protein,
  3. decreased glucose

Investigation IMAGING for Brain Abscess –

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