Review of brain abscesses

A brain abscess is a focus of infected brain parenchyma. Most brain abscesses result from infection, trauma, or surgery. Although some abscesses cause localizing neurological signs or symptoms, most present with nonspecific symptoms such as headache, fever, lethargy, and malaise. Because the presentation is often nonspecific, a high index of suspicion is crucial to early detection and diagnosis. Although computed tomography and magnetic resonance imaging are highly sensitive detectors of brain abscess, they are less specific. Except in cases with accessible systemic infection, brain biopsy, or resection is often needed to confirm the diagnosis and to obtain tissue for culture. Patient outcome is usually favorable with early detection and aggressive treatment. Abscess rupture, particularly into the cerebral ventricles, often has dire neurological consequences that may prove fatal.