Surgery consists of opening and draining the abscess and is usually accompanied by cultures of the fluid. This allows antimicrobial treatment to be adjusted to the specific microorganism causing the infection. The specific surgical procedure depends on the size and depth of the mass. The entire mass may be removed (excised) if it is near the surface and completely encapsulated (surrounded by a membrane).
Needle aspiration guided by CT scan or MRI scan may be needed for a deep abscess. This may also include injecting antimicrobials directly into the mass.
Osmotic diuretics and steroids may also be used to reduce swelling of the brain.
If untreated, the disorder is almost always fatal. The outcome is usually improved with the use of CT and MRI scans for accurate diagnosis and by the administration of broad-spectrum antimicrobials.
The death rate is around 10% with treatment. Neurologic changes may be chronic or may resolve over time. Seizures or neurologic losses (inability to move, speak, see) may occur after surgery.
Go to the emergency room or call the local emergency number (such as 911) if symptoms suggestive of brain abscess occur. Cerebral abscess is a medical emergency!
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