Prognosis
- The prognosis of brain abscess has improved over time due to advancements in neurosurgical techniques, cranial imaging, and antimicrobial regimens
- However, brain abscess is associated with an increased long-term risk of mortality and new-onset epilepsy for several years after infection
- The 1-year, 2-5 year, and 6-30 year mortality rates of patients after brain abscess were 21%, 16%, and 27% respectively
- Among the 30-day survivors of brain abscess, new-onset epilepsy occurred in 32% compared to 2% in matched population controls
Risk factors
- Risk factors for brain abscess include immunocompromised status, chronic sinusitis, and a history of head trauma
- Other factors such as older age, black race, ear infection or mastoiditis, and pre-existing conditions like hemiplegia and a high comorbidity burden have also been associated with increased risk
- Important risk factors for epilepsy following brain abscess were seizures during admission for brain abscess, neurosurgery, alcoholism, frontal lobe abscess, and stroke
Clinical course
- Clinically, patients with a brain abscess may present with headache, fever, neurological deficits, altered mental status, and signs of increased intracranial pressure
- The clinical presentation can vary depending on the location and size of the abscess and the patient's immune status
- The median duration between brain surgery and the development of a postoperative brain abscess was 1.5 months
In conclusion, brain abscess is a serious condition with significant long-term risks, including mortality and new-onset epilepsy. While advancements in neurosurgical techniques, imaging, and antimicrobial treatments have improved the prognosis, the condition remains associated with high morbidity and mortality. Risk factors are varied and include both patient-specific and disease-specific factors. The clinical course can vary widely, depending on the location and size of the abscess and the patient's immune status.