We treat all brain and spinal cord abscesses with very strong medicine that kills bacteria (antibiotics). For some children, this therapy is enough. They do not need surgery.
In some cases, we perform surgery to take a small sample of the abscess or to drain the abscess. Doctors test the sample to find out what kind of bacteria is causing the infection. Once we know the type of bacteria involved, we can choose the best medicine to treat the abscess.
Brain Abscess or Spinal Abscess Surgery Options
When a child needs surgery to treat a brain abscess, it is most often because the abscess is large. It is creating pressure inside the head that causes symptoms.
There are two options for operating on a brain abscess. Both drain the pus, reducing the pressure in your child's head. Your child's neurosurgeon will talk with you about which option may be best for your child:
- Burr hole: After identifying the location of the abscess, your child's neurosurgeon drills a small hole in the skull. Then the neurosurgeon inserts a needle in this burr hole to make a small prick in the abscess. This drains the pus.
- • Craniotomy: Neurosurgeons may perform this operation if they need more direct access to your child's brain. Neurosurgeons cut and remove a part of the skull (cranium) and the tough membrane that protects the brain (dura mater). Using highly technical equipment, they drain the pus. Then neurosurgeons close up the skull using the same piece of bone they removed. They may use hardware such as micro plates, screws and wires to close your child’s skull. If the skull bone is infected, neurosurgeons remove it while the infection is treated. Later, they replace it with an artificial material.
A spinal abscess usually requires surgery to drain the pus and relieve pressure on the spinal cord. If your child is having symptoms including leg weakness, trouble walking, or difficulty with bowel and bladder function, they may need surgery right away.