BRAIN ABSCESS.pptx

notes for nursing students

1. BRAIN ABSCESS

2. introduction A brain abscess , also known as a cerebral abscess or CNS abscess , is an abscess within the brain tissue caused by inflammation and collection of immune cells and infected material originating from local or remote infection sources .

3. A brain abscess is a rare, life-threatening infection of the brain. Local sources may include ear infections, a dental abscess, infection of the paranasal sinuses, or epidural abscess, while remote sources may include infections in the lung, heart or kidney.

4. definition It is free or encapsulated collection of infectious material of brain parenchyma between dura and archnoid lining.

5. Types 1. intracranial subdural abscess 2.intracranial epidural abscess 3.spinal epidural infection/ abscess 4.intermedullary abscess 5.cerebritis 6.fungal brain abscess

6. causes Streptococcus, candida Chronic mastoiditis, sinusitis Head trauma, craniotomy Spinal injury, meningitis Immunosuppressed (HIV) M. tuberculosis

7. pathophysiology Due to etilogical factor That cross the blood brain barrier reaches to brain Inflammation of parenchymal layer of brain Cerebritis necrotic lesions(1) Organism through the meningis or middle ear infection Cause inflammation and purulant drainage between dura and archnoid layer Subdural abscess(2)

8. Any head trauma or sinusitis Epidural abscess(3) Causative agent may be from spinal injury Cause spinal epidural abscess(4) If bacteria reaches to lumbosacral region Intermedullary abscess(5)

9. Clinical feature Headache with purulent material collect in brain, increase ICP Nausea , vomiting, otitis media Nucchal rigidity Kerning sign-inability to extend knees more than 135 degress , brudzinski sign-severe neck stiffness causes a person hips and knees to flex when neck is flexed Behaviour changes Decrease sensory and motor functioning Aphasia , ataxia- impaired coordination

10. Diagnostic test Blood test - to determine whether there is an infection. If results show elevated levels of white-blood cells, there most probably is an infection. Chest X-ray - to determine whether the patient has a lung infection. Imaging scans: MRI (magnetic resonance imaging) scan - an MRI machine uses a magnetic field and radio waves to create detailed images of the inside of the body. Unlike CT scanning or general x-ray studies, no ionizing radiation is involved with an MRI. It is a painless procedure

11. MRI

12. CT (computed tomography) scan - In these imaging scans the abscess will appear as one or more spots. CT-guided aspiration - this is a type of needle biopsy. With the help of a CT scan to guide him/her, the neurologist inserts a needle into where the abscess is and takes a sample of pus for analysis. This will help determine what is causing the abscess, and consequently, how to treat it.

13. Management Antibiotics Laminectomy of surgical drainage needle biopsy, under CT guidance may used for drainage Antimicrobial therapy for streptococcus. Anti tuberculosis THERAPY if cause is tuberculi Corticosteroids for cerebral edema Anticonvulsants to manage seizures

14. Craniotomy - this is a surgical operation in which an opening is made in the skull. The surgeon shaves a small area of scalp hair. A small piece of bone is removed in order to gain access to the brain. Often with the a CT scanner for guidance, the abscess is either drained of pus (aspiration), or removed (excision). The bone is replaced. The skin is stitched

15. Complications Brain abscess rupture into ventriclar space causing increase severity of headache. Brain stem herniation Permanent neurologic deficit, Flaccid paralysis with sensory loss Intracranial temporal complications

16. Nursing DIAGNOSIS Headache related to brain abscess. Altered mental activity related to pressure on brain nerve. Risk of infection related to seizures. Decreased sensory function related to brain abscess. Altered activity level due to brain absces