Diabetic ketoacidosis in paediatrics

1. PRESENTED BY:
BARTHOLOMEW ONOGWU
U2017/4710065
Cerebral Abscess

2. INTRODUCTION
Cerebral abscess /Brain abscess is an abscess within
the brain tissue caused by inflammation and
collection of immune cells and infected material
originating from local or remote infection sources.
it is a rare and life threatening infection of the brain

3. Local sources may include ear infections ,a dental
abscess,infection of the paranasal sinuses or epidural
abscess
Remote sources :infections in lungs ,heart or kidney

4. Types
1.Intracranial subdural abscess
2. Intracranial epidural abscess
3. Spinal epidural infection/abscess
4. Intermedullary abscess
5. Cerebritis
6. Fungal brain abscess

5. Causes
Streptococcus,candida
Chronic mastoiditis,sinusities
Head trauma,craniotomy
Spinal injury,meningitis
Immunosuppressed /Hiv
M.tuberculosis

6. Due to etiological factor -> cross BBB to the brain ->
Inflammation of parenchymal layer of brain -> Cerebritis
necrotic lesions—>Organism through the meningitis or
middle ear infection -> Cause inflammation and purulant
drainage between dura and archnoid layer -> Subdural
abscess.
PATHOPHYSIOLOGY

7. CLINICAL MANIFESTATIONS
- Headache with purulent material collect in
brain,increase ICP
- Nausea,vomiting,otitis media
- Nucchal rigidity
- Kerning sign-inability to external knees more than 135
degrees
- Brudzinski sign-severe neck stiffness causes a person
hips and knees to flex when neck is flexed

8. - Behaviour changes
- Decrease sensory and motor functioning
- Aphasia ,ataxia-impaired coordination

9. DIAGNOSTIC
EVALUATION
1. Blood test - to determine whether there is an
infection .If results show elevated levels of white-
blood cells
2. Chest X-ray - determine whether the patient has a
lung infection
3. MRI -
4. CT scan

10. 5. CT-guided aspiration

11. MANAGEMENT
1. Antibiotics
2. Laminectomy of surgical drainage
3. Needle biopsy
4. Antimicrobial therapy for streptococcus
5. Anti tuberculosis therapy if cause is tuberculi
6. Corticosteroids for cerebral edema
7. Anticonvulsants to manage seizures

12. COMPLICATIONS
1. Brain abscess rupture into ventricular space
causing increase severity of headache
2. Brain stem herniation
3. Permanent neurologic deficit
4. Flaccid paralysis with sensory loss
5. Intracranial temporal complications
6. Headache related to brain abscess
7. Altered mental activity related to pressure on
brain nerve

13. 8. Risk of infection related to seizures
9. Decreased sensory function related to brain
abscess
10. Altered activity level due to brain abscess