A brain abscess is a medical emergency. Pressure inside the skull may become high enough to be life threatening. You will need to stay in the hospital until the condition is stable. Some people may need life support.
Medicine, not surgery, is recommended if you have:
- A small abscess (less than 2 cm)
- An abscess deep in the brain
- An abscess and meningitis
- Several abscesses (rare)
- Shunts in the brain for hydrocephalus (in some cases, the shunt may need to be removed temporarily or replaced)
- An infection called toxoplasmosis in a person with HIV/AIDS
You may be prescribed several different types of antibiotics to make sure treatment works.
Antifungal medicines may also be prescribed if the infection is likely caused by a fungus.
Surgery is needed if :
- Increased pressure in the brain continues or gets worse
- The brain abscess does not get smaller after medicine
- The brain abscess contains gas (produced by some types of bacteria)
- The brain abscess might break open (rupture)
- The brain abscess is large (more than 2 cm)
Surgery consists of opening the skull, exposing the brain, and draining the abscess. Laboratory tests are often done to examine the fluid. This helps identify the cause of the infection, so that the right antibiotics or antifungal medicine can be prescribed.
Needle aspiration guided by CT or MRI scan may be needed for a deep abscess. During this procedure, medicines may be injected directly into the mass.
Certain diuretics (water pills) and steroids may also be used to reduce the swelling of the brain.