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Brain Abscess
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Focal pyogenic infection of brain parenchyma
                  • Typically bacterial; fungal or parasitic is less common

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Antkowiak Ł et al: Clinical features, microbiology, and management of pediatric brainstem abscess. Childs Nerv Syst. 36(12):2919-26, 2020
                                            2. Jeong DE et al: Brain abscess masquerading as brain infarction. Brain Sci. 10(7), 2020
                                            3. Lai PH et al: Susceptibility-weighted imaging provides complementary value to diffusion-weighted imaging in the differentiation between pyogenic brain abscesses, necrotic glioblastomas, and necrotic metastatic brain tumors. Eur J Radiol. 117:56-61, 2019
                                            4. Mameli C et al: Brain abscess in pediatric age: a review. Childs Nerv Syst. 35(7):1117-28, 2019
                                            5. Oliveira CR et al: Brain magnetic resonance imaging of infants with bacterial meningitis. J Pediatr. 165(1):134-9, 2014
                                            6. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 1: techniques and bacterial infections. J Neuroimaging. 22(2):e42-51, 2012
                                            7. DeMuri GP et al: Complications of acute bacterial sinusitis in children. Pediatr Infect Dis J. 30(8):701-2, 2011
                                            8. Hsiao SY et al: The experiences of non-operative treatment in patients with bacterial brain abscess. Clin Microbiol Infect. 17(4):615-20, 2011
                                            9. Piatt JH Jr: Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study. J Neurosurg Pediatr. 7(6):567-74, 2011
                                            10. Arlotti M et al: Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses. Int J Infect Dis. 14 Suppl 4:S79-92, 2010
                                            11. Kuczkowski J et al: Pediatric otogenic intracranial abscesses. Otolaryngol Head Neck Surg. 143(3):470; author reply 470-1, 2010
                                            12. Nath K et al: Assessment of therapeutic response in patients with brain abscess using diffusion tensor imaging. World Neurosurg. 73(1):63-8; discussion e6, 2010
                                            13. Shachor-Meyouhas Y et al: Brain abscess in children - epidemiology, predisposing factors and management in the modern medicine era. Acta Paediatr. 99(8):1163-7, 2010
                                            14. Tsai BY et al: Pott's puffy tumor in children. Childs Nerv Syst. 26(1):53-60, 2010
                                            15. Gelabert-González M et al: Management of brain abscess in children. J Paediatr Child Health. 44(12):731-5, 2008
                                            16. Kao KL et al: Brain abscesses in children: analysis of 20 cases presenting at a medical center. J Microbiol Immunol Infect. 41(5):403-7, 2008
                                            17. Gupta RK et al: High fractional anisotropy in brain abscesses versus other cystic intracranial lesions. AJNR Am J Neuroradiol. 26(5):1107-14, 2005
                                            18. Tsuyuguchi N et al: Evaluation of treatment effects in brain abscess with positron emission tomography: comparison of fluorine-18-fluorodeoxyglucose and carbon-11-methionine. Ann Nucl Med. 17(1):47-51, 2003
                                            19. Lai PH et al: Brain abscess and necrotic brain tumor: discrimination with proton MR spectroscopy and diffusion-weighted imaging. AJNR Am J Neuroradiol. 23(8):1369-77, 2002
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Focal pyogenic infection of brain parenchyma
                                                            • Typically bacterial; fungal or parasitic is less common

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Antkowiak Ł et al: Clinical features, microbiology, and management of pediatric brainstem abscess. Childs Nerv Syst. 36(12):2919-26, 2020
                                                                                      2. Jeong DE et al: Brain abscess masquerading as brain infarction. Brain Sci. 10(7), 2020
                                                                                      3. Lai PH et al: Susceptibility-weighted imaging provides complementary value to diffusion-weighted imaging in the differentiation between pyogenic brain abscesses, necrotic glioblastomas, and necrotic metastatic brain tumors. Eur J Radiol. 117:56-61, 2019
                                                                                      4. Mameli C et al: Brain abscess in pediatric age: a review. Childs Nerv Syst. 35(7):1117-28, 2019
                                                                                      5. Oliveira CR et al: Brain magnetic resonance imaging of infants with bacterial meningitis. J Pediatr. 165(1):134-9, 2014
                                                                                      6. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 1: techniques and bacterial infections. J Neuroimaging. 22(2):e42-51, 2012
                                                                                      7. DeMuri GP et al: Complications of acute bacterial sinusitis in children. Pediatr Infect Dis J. 30(8):701-2, 2011
                                                                                      8. Hsiao SY et al: The experiences of non-operative treatment in patients with bacterial brain abscess. Clin Microbiol Infect. 17(4):615-20, 2011
                                                                                      9. Piatt JH Jr: Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study. J Neurosurg Pediatr. 7(6):567-74, 2011
                                                                                      10. Arlotti M et al: Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses. Int J Infect Dis. 14 Suppl 4:S79-92, 2010
                                                                                      11. Kuczkowski J et al: Pediatric otogenic intracranial abscesses. Otolaryngol Head Neck Surg. 143(3):470; author reply 470-1, 2010
                                                                                      12. Nath K et al: Assessment of therapeutic response in patients with brain abscess using diffusion tensor imaging. World Neurosurg. 73(1):63-8; discussion e6, 2010
                                                                                      13. Shachor-Meyouhas Y et al: Brain abscess in children - epidemiology, predisposing factors and management in the modern medicine era. Acta Paediatr. 99(8):1163-7, 2010
                                                                                      14. Tsai BY et al: Pott's puffy tumor in children. Childs Nerv Syst. 26(1):53-60, 2010
                                                                                      15. Gelabert-González M et al: Management of brain abscess in children. J Paediatr Child Health. 44(12):731-5, 2008
                                                                                      16. Kao KL et al: Brain abscesses in children: analysis of 20 cases presenting at a medical center. J Microbiol Immunol Infect. 41(5):403-7, 2008
                                                                                      17. Gupta RK et al: High fractional anisotropy in brain abscesses versus other cystic intracranial lesions. AJNR Am J Neuroradiol. 26(5):1107-14, 2005
                                                                                      18. Tsuyuguchi N et al: Evaluation of treatment effects in brain abscess with positron emission tomography: comparison of fluorine-18-fluorodeoxyglucose and carbon-11-methionine. Ann Nucl Med. 17(1):47-51, 2003
                                                                                      19. Lai PH et al: Brain abscess and necrotic brain tumor: discrimination with proton MR spectroscopy and diffusion-weighted imaging. AJNR Am J Neuroradiol. 23(8):1369-77, 2002