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Brain Abscess

  • Overview

    A brain abscess is a brain infection that may cause problems with a child's brain and spinal cord function. The team at Boston Children's Hospital works quickly to identify a child's brain abscess and take all the steps necessary to remove it. A brain abscess:

    • can occur in all children, but are more common in young school-aged children
    • occur twice as often in boys than in girls
    • may be the result of a virus or infection
    • can be detected through a variety of tests, including X-ray, MRI and CT scans
    • may be treated with medication, but surgery may be required

    Children's Hospital Boston
    300 Longwood Avenue
    Fegan 11 and Hunnewell 2
    Boston MA 02115

  • In-Depth

    What causes a brain abscess?

    The most common causes are viruses and bacteria. Several factors may increase your child's chances of developing a brain abscess:

    Is a brain abscess common?

    Brain abscesses can occur in any child, but they're more common in young, school-aged children and occur twice as often in boys than in girls.

    What are the symptoms of a brain abscess?

    Symptoms vary from child to child, based on their age. The most common include:

    • For babies and younger children
      • fever
      • a full or bulging soft spot on the top of the head
      • sleepiness or less alert than usual
      • increased irritability
      • high-pitched cry
      • poor feeding
      • projectile vomiting
      • seizures
    • For older children
      • fever
      • complaints of severe headaches
      • nausea and vomiting
      • changes in personality or behavior
      • changes in speech
      • problems walking
      • increased movement in the arms or legs (spasticity)
      • seizures
  • Tests

    How does a doctor know that it's a brain abscess?

    During the physical examination, your child's doctor will obtain a complete medical history of your child. In addition to urine and stool tests and a measure of your head's circumference, a doctor may do any of these diagnostic tests:

    • X-ray
      • uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
    • magnetic resonance imaging
      • also called an MRI
      • uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. I
      • Intravenous (IV) contrast agents may be given during the scan to better see the abscess
    • computerized tomography scan
      • also called a CT or CAT scan
      • uses a combination of x-rays and computer technology to shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
    • sputum culture
      • tests the stuff coughed up from the lungs and into the mouth.
      • helps to see if an infection is present
    • lumbar puncture
      • also called a spinal tap
      • a special needle is placed into the lower back, into the spinal canal.
      • measures the pressure in the spinal canal and brain
      • a small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems.
    • Electroencephalogram
      • also called an EEG
      • records the brain's continuous, electrical activity by means of electrodes attached to your scalp
    • intracranial pressure monitoring
      • also called ICP
      • measures the pressure inside of your head
  • The key to treating a brain abscess is early detection and treatment. A child with a brain abscess requires immediate hospitalization, treatment and close monitoring. After your child is hospitalized, Children's team of doctors and nurses will educate your family on how to best care for your child at home.

    Traditional treatments for a brain abscess

    The goal of treatment is to reduce the pressure in your child's head and to treat the infection.

    • Medications: used to control the infection, seizures, fever and/or other conditions that may be present
    • Surgery: required if the medication doesn't work, the abscess gets bigger or there is a chance of the abscess rupturing
    • Breathing machine: used in severe cases to help your child breathe easier
    • Therapy: physical, occupational or speech therapy to help your child regain muscle strength and/or speech skills
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