The brain abscess It is a type of brain infection that some specialists define as a suppurative process, in which there is an accumulation of pus and dead cells. It is a serious and life-threatening medical condition, despite being rare. Bacterial agents are generally the most common cause of brain abscess development..
Despite the fact that the diagnosis of this infection is complicated, especially in the early stages of presentation of symptoms, new brain imaging methods (magnetic resonance, computed tomography, etc.) have significantly facilitated the accurate and early identification of brain abscesses.
On the other hand, therapeutic interventions for brain abscesses tend to focus on the administration of antibiotic drugs and surgical interventions..
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A cerebral access is defined as a focal infection within the brain parenchyma, that is, in the brain tissue. In addition, it is a form of intracranial suppuration that represents a medical emergency that puts the life of the affected person at risk..
Generally, brain abscesses begin by showing a localized ischemic or necrotic area, with inflammation of the brain tissue. This is followed by the deposition of leukocyte antigens.
Leukocyte antigens fulfill an immune function and, therefore, try to protect the body from the agents that cause infection. At the macroscopic level, the deposit of this type of agent is manifested by the presence of pus.
Pus is a thick liquid with a yellowish or greenish color, which is secreted or oozed by the inflamed tissues. Generally, this substance is made up of serum, leukocytes, dead cells and other agents..
After these events, the area of the necrotic zone tends to increase and also the suppuration of pus. Next, the affected or purulent area is delimited and begins to develop a neo-vascularization (formation of new blood vessels) around it.
In the final phase, the affected area is surrounded by a capsule that keeps the infectious process localized..
Brain abscesses are a medical condition that has become rare or frequent in more developed countries, especially since the second half of the 20th century, thanks to medical and technological advances..
Statistical data show us that brain abscesses present an incidence that ranges between 0.3-1 cases per 100,000 people / year, in the general population.
Although the low incidence of this pathology is mainly due to the introduction of new antimicrobial drugs and the development of brain imaging studies, it remains a potentially fatal condition.
When the capsule of a brain abscess ruptures, the person can die in about 80%. In addition, of those who survive, between 20-79% will present neurological sequelae after the infectious process.
In relation to sex, some specialists point out that brain abscesses are more frequent in men than in women. On the other hand, in terms of age, brain abscesses are considered a rare disease or pathology in pediatric age.
Studies show that brain abscesses have an estimated incidence of about 4 cases per million inhabitants of child age.
Our central nervous system (CNS) is really susceptible to any damage or injury that affects the nervous tissue. Thus, infectious processes can give rise to a wide variety of neurological symptoms when they affect brain tissue and adjacent structures..
Patients who suffer from this type of localized infection usually present a non-specific clinical picture.
The characteristic signs and symptoms of brain abscesses appear insidiously, evolving over days or weeks, generally, the duration of symptoms is at least two weeks.
The clinical course of brain abscesses usually includes:
On the other hand, it is also possible that brain abscesses debut with other clinical forms;
In addition to this, if the diagnosis is made late, the brain abscess progresses, increasing pus suppuration, cerebral edema and intracranial pressure. Because of this, some serious neurological symptoms may appear such as:
Brain abscesses develop as a consequence of the existence of an infectious process.
Despite the fact that this medical entity usually has a diverse etiology, there are risk factors that allow the approximate cause and location of the infection to be identified.
Some of the predisposing factors are:
In this way, different infectious agents, viruses or bacteria, can reach the brain tissue, giving rise to the formation of the purulent capsule..
In the case of brain abscesses of bacterial origin, streptococci are the most common pathogens, giving rise to approximately 70% of cases.
In many cases of brain abscess, the diagnosis is not easy, and since the symptoms are nonspecific. Much of the symptoms resemble those characteristic of other pathologies or diseases of neurological origin.
In the case of brain abscesses, a neurological examination performed through various brain imaging tests, such as magnetic resonance imaging or computed tomography, is essential..
Neuroimangen tests allow us to determine at the anatomical level the presence of brain lesions, such as abscesses.
On the other hand, it is also common for the medical specialist in charge of the case to request other laboratory tests such as blood cultures or lumbar puncture to determine the presence of an infectious agent..
Currently, medical advances have made it possible to develop different therapeutic options. The choice of one of these will depend on the characteristics of the brain abscess and the clinical characteristics of the affected person..
Typically, the most common treatment includes pharmacological and surgical intervention.
The approach to brain abscesses through pharmacological treatment is usually focused on the use of antibiotic therapies, called antibiotic therapy..
Antibiotics are usually recommended for the treatment of brain abscesses that do not exceed 2.5 centimeters.
In the first weeks, high doses of these drugs are usually used to ensure sufficient penetration and concentration of antibiotics in brain tissue.
Normally, this type of treatment lasts approximately 6-8 weeks, and can even reach 3-6 months in severe cases that cannot be operated on..
Surgical interventions are used both for the therapeutic approach and for the realization of the diagnosis, they are normally indicated in those abscesses that have a size greater than 2.5 centimeters.
Various neurosurgery techniques allow a puncture-biopsy to be performed in the affected area. Thus, these procedures allow the evacuation of pus, leading to a decompression of brain tissue.
On the other hand, complete capsule removal usually involves a procedure with great risks for the patient, therefore, they are restricted to severe cases in which the other measures have not been effective..
When a diagnosis of brain abscess is made, it is essential to carry out an early medical approach, treat secondary neurological complications and, in addition, carry out a follow-up.
Although current therapies help to control the progress of this pathology, those affected die in up to 5-10% of cases.
Although it is a pathology that puts the life of the person at risk, mortality has been reduced by approximately 25%, in cases of stay in intensive care medical units.
On the other hand, neurological sequelae are prevalent (30-5%), some are mild, while others may involve more significant symptoms such as epilepsy..
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