Brain Abscess/Subdural Empyema

Also known as: cerebral abscess, CNS abscess.

What is a brain abscess?

Subdural empyema and brain abscess are serious infections of the brain where pus accumulates inside or around the brain, often as a consequence of sinusitis, ear infections, dental caries or even urine infections. These can result in severe headaches, drowsiness or seizures. An urgent intervention is often necessary. Hence a consultation or visit to the emergency room is recommended.

What causes brain abscess?

Brain abscesses occur due to an infection with bacteria, fungi or viruses, that spreads from either another close-by part of the body (for example, an ear infection); or through the bloodstream or directly through a penetrating injury to the head.

Children at increased risk for developing a brain abscess include:

  • Those who have a infection of the coverings of the brain (meningitis)
  • Children with a congenital heart defect
  • Chronic ear and sinus infection
  • Teeth and jaw infections
  • The presence of foreign material involving the brain  (like cerebrospinal shunts)
  • Diabetes
  • Children who have congenital or acquired difficulty in fighting infections (immune problems)

What are the symptoms of brain abscess? 

In babies and young infants, symptoms include:

  • fever
  • a full/bulging fontanelle
  • drowsiness and/or irritability
  • a high pitched cry
  • difficulty feeding
  • vomiting
  • seizures

Older children may present with:

  • gradual or sudden fever
  • vomiting
  • headache
  • seizures
  • stiff limbs
  • behavior and/personality changes
  • difficulty talking and walking.

What are brain abscess care options?

Depending on a number of factors, the goal of management is to diagnose and treat the problem early. Hospitalization with antibiotics, other medications depending on complications present and possibly surgery are likely.

Physical, occupational and speech therapy may be required subsequently to assist the child to reach his/her full potential.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: October 10, 2023 03:31 PM

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