Brain, Nervous System and Mental Conditions

Brain Abscess or Spinal Abscess

What is a brain abscess or spinal abscess?

An abscess is a collection of pus caused by an infection. Brain and spinal abscesses rarely happen in children. But when they do, they can cause harm by pressing on brain tissues or blocking the flow of blood to parts of the brain.

In the central nervous system (CNS), an abscess can happen:

  • In brain tissue or around the lining of the brain
  • In the outer covering of the spinal cord (the epidural space)
  • Inside the sac that contains the spinal cord
  • On the bones of the spine (vertebrae)

  • Brain abscesses usually are caused by bacteria or fungi that infect part of the brain. The infection causes the area to swell (inflammation). A membrane forms around the infected area. This can help protect your child’s brain by limiting the infection to 1 area. But if the area continues to swell, it can block blood flow or put pressure on parts of the brain.

    Brain abscesses usually are caused by bacteria from an ear, sinus, mouth or tooth infection. The bacteria travel to the brain through the blood. A brain abscess can also be caused by an infection in the central nervous system, such as meningitis. It may also happen to children who have cyanotic heart disease.

    Spinal abscesses also are caused by infections in other parts of the body that spread through the blood.

Brain or Spinal Abscess at Seattle Children’s

Children rarely get an abscess of their brain or spinal cord. When they do, doctors from our region refer their patients to Seattle Children’s for treatment. Our region is Washington, Alaska, Montana and Idaho.

If you would like an appointment, ask your child’s primary care provider for a referral. If you have a referral, call 206-987-2016 to make an appointment.

If you have questions, please contact our Neurosciences Center at 206-987-2016.

    • Sometimes a child with an abscess needs surgery. Our neurosurgeons are experienced in procedures to treat both brain and spinal abscesses. Seattle Children’s is the only hospital in the region with round-the-clock, on-site coverage by a pediatric neurosurgeon.
    • Our Neurosciences Center is ranked #1 in the Northwest and among the best in the nation by U.S. News & World Report.
    • Our Infectious Diseases and Virology team is expert at choosing medicines best suited to your child’s condition, in the right amounts (doses) for growing children.
    • If an abscess harms your child’s brain or spinal cord, specialists in Rehabilitation Medicine and Neuropsychology provide treatment and services so your child has the best possible recovery.

    • Having a condition that affects the brain or spinal cord can be scary and stressful for the whole family. During visits, we take time to explain your child’s condition. We help you fully understand your treatment options and make the choices that are right for your family.
    • Our doctors, nurses, child life specialists and social workers help your child and your family through the challenges of their condition. We connect you to community resources and support groups.
    • At Seattle Children’s, we work with many children and families from around the Northwest and beyond. We can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.

    • Children don’t react to illness, pain, medicine or surgery in the same way as adults. They need – and deserve – care designed just for them. They need a healthcare team specially trained to understand and meet their needs.
    • Our doctors have special training to diagnose and treat children. They are focused on how today’s treatment will affect your child as they develop and become an adult.
    • Our experts base their treatment plans on years of experience and the newest research on what is best for children and teens.
    • As your child grows, we meet their changing needs, whether they are a youngster going back to school after brain surgery or a teen taking more responsibility for their health.

Symptoms of a Brain or Spinal Abscess

Some symptoms of a brain or spinal abscess are the same as many other conditions, like headache and fever. Our team has the experience to tell an abscess from other health problems to make sure your child gets the right treatment.

  • If your child has a brain abscess, they may have some of these symptoms:

    • Headache
    • Stiff neck, shoulders or back
    • Neck, shoulder or back ache
    • Vomiting
    • Fever or chills
    • Sleepiness, confusion or other changes in thinking
    • Changes in vision
    • Problems talking
    • Problems with walking or other movements

  • Symptoms of a spinal abscess depend on the location of the abscess. In general, they include:

    • Weakness
    • Tingling, numbness or loss of feeling in any body part
    • Loss of bladder or bowel control
    • Unable to pass urine
    • Back or leg pain
    • Fever

Diagnosing Brain Abscess or Spinal Abscess

Your child’s doctor will examine your child to find out if they have problems moving, feeling or thinking that might point to an abscess. In addition, blood tests and imaging studies can help doctors find out the cause of problems.

  • If your child’s doctor suspects a brain abscess, your child may have:

    • Complete blood count (CBC) to measure the number and size of red and white blood cells
    • Test for bacteria in a sample of blood (blood culture)
    • CT (computed tomography) scan of the head
    • MRI (magnetic resonance imaging) of the head
    • Chest X-ray
    • EEG (electroencephalogram) to find problems with electrical activity in the brain

  • If your child’s doctor suspects a spinal abscess, your child may have:

    • CT (computed tomography) scan
    • MRI (magnetic resonance imaging)
    • Sample of the abscess taken and tested for bacteria or fungi

Treating a Brain Abscess or Spinal Abscess

We treat all brain and spinal cord abscesses with very strong medicine that kills bacteria (antibiotics). Some children also need surgery.

  • To decide the best medicine for your child, sometimes we do surgery to take a small sample of the abscess or to drain it. 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, including antibiotics, to treat the abscess.

  • 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 and causing symptoms.

    There are 2 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

    First, we find the exact location of the abscess. Then your child’s neurosurgeon:

    • Drills a small hole in the skull.
    • Inserts a needle in this hole, called a burr hole.
    • Makes a small prick in the abscess. This drains the pus.

    Craniotomy

    Neurosurgeons may do this operation if they need direct access to your child’s brain. During a craniotomy, neurosurgeons:

    • Cut and remove a part of the skull (cranium).
    • Cut the tough membrane that protects the brain (dura mater).
    • Drain the pus using highly technical equipment.
    • Close up the skull. Usually surgeons use the same piece of bone they removed. Sometimes they 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.
    If the skull bone is infected, neurosurgeons remove it while the infection is treated. Later, they replace it with an artificial material.

  • Usually, doctors treat a spinal abscess with surgery. This drains the pus and eases pressure on the spinal cord. Your child may need surgery right away if they are having symptoms such as:

    • Leg weakness
    • Trouble walking
    • Problems with bowel or bladder control

  • After your child receives any urgent or emergency treatment they need, the team at Seattle Children’s plans and provides ongoing care so your child has the best possible outcome. We evaluate all your child’s health needs and work with you to create a care plan that fits your child and family.

    If an abscess harms your child’s brain or spinal cord, we provide treatment and services so your child has the best possible recovery.

    Our team is experienced in helping children return to school and other important activities after brain or spinal surgery. We also work with you to find resources in your community.

Contact Us

  • If you would like an appointment, ask your child’s primary care provider for a referral.
  • If you have a referral, call 206-987-2016 to make an appointment.
  • Providers, see how to refer a patient.
  • If you have any questions, please contact us at 206-987-2016 or 844-935-3467 (toll free).