Intracranial Abscess

Abscess formation in the brain can be a devastating complication of sinus infections or bone infections (osteomyelitis) of the skull. Occasionally, abscesses start from an infection from other parts of the body. Abscesses in the brain frequently occur in multiples. One of the problems in the treatment of brain abscesses is that surgical drainage of the abscesses is often required for cure. Unfortunately, normal brain tissue surrounding the abscess may be unavoidably damaged by such surgery. Fine needle aspiration of the abscesses is being performed with greater frequency to avoid this problem.

Antibiotics are used for treatment, but they may not penetrate well into brain abscesses. Furthermore, white blood cells, which kill infecting bacteria, may not have enough oxygen to effectively eliminate the infection if they are functioning deep in the abscess at a distance from their normal blood supply. White blood cells require a minimum level of oxygen to kill bacteria.

Most intracranial abscesses are caused by anaerobic bacteria (bacteria that function optimally in low oxygen concentrations). Hyperbaric oxygen therapy raises the oxygen level in the region of the abscess, exposing the bacteria to levels which may inhibit or kill them, as well as providing sufficient oxygen for white blood cells to exercise their killing power.

The average mortality rate from intracranial abscess reported in six large studies was 20 percent when hyperbaric oxygen was not used. Among the 48 known cases treated with hyperbaric oxygen to date, the mortality rate has been only 2 percent. Additionally, most of the patients treated with hyperbaric oxygen have returned to their regular daily activity after recovery, with less apparent brain damage. Therapy with hyperbaric oxygen carries minimal risks.

References:

  1. Lampl L, Frey G, Bock KH. Hyperbaric oxygen in intracranial abscesses - update of a series of 13 patients (abstract). Undersea Biomed Res 1992:19(Suppl):83.
  2. Mathieu D, Wattel F, Neviere R, Bocquillon N. Intracranial infections and hyperbaric oxygen therapy: A five year experience (abstract). Undersea Hyperbaric Med 1999;26(Suppl):67.
  3. Sutter B, Legat JA, Smolle-Juttner FM. Brain abscess before and after HBO. 12th Proc Sc Soc Physiol, Styria (Austria) 1996.

Center for Hyperbaric Medicine