Brain abscess management [Neurosurgery Wiki]

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====== Brain abscess management ======

see also [[Brain abscess treatment]].

===== General outline =====


Obtain [[blood culture]]s.

see [[Blood culture for brain abscess]].

Initiate [[antibiotic]] [[therapy]], preferably after specimen obtained.

Avoid [[LP]].

[[Anticonvulsant]]s: Indicated for [[seizure]]s, prophylactic use is optional.

[[Steroid]]s: Controversial. Reduces [[edema]] , but may impede therapy.

===== Antibiotic selection =====

see [[Antibiotics for Brain Abscess]].

===== Glucocorticoids (steroids) =====
see [[Steroids for Brain Abscess]].

===== Follow up imaging =====
If therapy is successful, imaging should decrease in:

1. Degree of ring enhancement.

2. Edema

3. Mass effect

4. Size of lesion: takes 1 to 4 weeks (2,5 mean). 95 % of lesions that will resolve with antibiotics alone decrease in size by 1 month.