What is a Brain Abscess? What are the Symptoms?
Brain abscess is the accumulation of inflammation in a certain area in the brain due to trauma or infection. Brain abscess is a serious disease that causes a high level of vital risks and can cause many different permanent problems in the human body.
Bacterial infections are the most common cause of brain abscesses. However, depending on the person’s immune system or the disease to which he is exposed, viruses and fungal diseases can also cause brain abscesses.
Symptoms of Brain Abscess
This bacterial infection that causes a brain abscess may have developed directly in the brain where they were found. However, in addition to this, the transfer of the infection that occurs in another part of the body, such as heart and liver infections, ear infections, sinusitis, and dental infections, directly to the brain through blood – vessels or in cases where it is in the head can also cause brain abscess formation. Brain abscess symptoms often appear slowly.
In some special cases, sudden symptoms and even seizures may occur due to the region where the brain abscess is located. Symptoms such as intense headache, vision problem, difficulty in speaking, confusion, irritability, pressurized vomiting, high fever, sensory loss and tingling sensation, neck stiffness, and seizures may occur due to brain abscess. Apart from these, swelling can be seen in the soft area known as fontanelle located on the top of the head in infant patients.
Brain Abscess Treatment
Brain abscesses can disrupt the blood circulation of the brain due to the swelling they create in the area where they are located, and in some cases, they can even burst, causing more serious problems. Although surgical techniques, antibiotic treatments, and imaging techniques have been developed today, brain abscesses seriously threaten human life due to the nervous system infection they cause. Especially thanks to antibiotic therapies, the incidence of brain abscesses developed due to bacterial reasons has decreased and disease control has become more accessible. However, even if drug treatment is applied, surgical techniques that enable the removal of the abscess from the region called surgical drainage, maintain their importance in the treatment of brain abscess.
Aspiration (Cleaning) of Brain Abscess with Burr – Hole
One of the most used techniques in the treatment of brain abscesses is the Burr Hole method. Burr Hole is the name given to the hole opened in the skull for the intervention to reduce the pressure in the brain. In aspiration with the Burr Hole method, first, the area where the brain abscess is located is determined exactly by computed tomography. According to the location of the brain abscess, from which point of the skull the entrance will be made and the depth of the brain abscess is calculated. After the necessary planning is done, a needle called a biopsy needle is passed through the skull and proceeded to the abscess, usually under local anesthesia. With this needle, the area where the abscess is located is drained and cleaned. The advantages of the Burr Hole method can be listed as the margin of error of the aspiration is very small, it can be applied with local anesthesia, and it provides the shortest way to reach the abscess in the brain and causes as little damage to the brain tissue as possible. It is also a practical method in emergency conditions and the absence of necessary equipment.
Brain Abscess and Craniotomy
Another technique in the treatment of brain abscess is craniotomy or craniectomy. In craniotomy, a piece of bone is removed from the skull and the abscess is removed from the brain. Depending on the patient’s condition, the surgeon decides whether to perform the craniotomy under general anesthesia or while the patient is awake.
During a craniotomy, which is mostly performed under general anesthesia, the patient’s head is fixed with a nail head. The skull bone tissue closest to the brain abscess is determined and marked by the surgeon. After the scalp in the relevant area is opened, the skull is opened with a device called a drill device.
After this point, the dura, located in the outermost layer of the brain, is reached. After the cerebral cortex is opened properly, the brain abscess is reached within the brain tissue. Finally, the inflammation-filled brain abscess is drained. A craniotomy can be performed quickly and in a more controlled manner thanks to the developing surgical technologies. In this way, surgical complications are greatly reduced compared to the past.
Prof.Dr. Ergün Dağlıoğlu (Eğitim Görevlisi), Beyin Cerrahı, Beyin Ve Sinir Cerrahisi