An abscess of the brain is an encapsulated collection of pus involving the brain or its membranes.

The abscess may result secondary to a direct extension of an infection such as osteomyelitis, infections of the middle ear and nasal sinuses; pus under the dura mater; or a penetrating wound or skull fracture. The condition also may occur from the spread of bacteria from bacterial endocarditis, bronchiectasis, or intravenous (IV) drug abuse.

The person may have a history of an infection with fever, chills and leukocytosis which may develop before the infection is encapsulated, and then subside. Signs and symptoms of the brain abscess may include a severe, intractable, and persistent headache usually localized over the infected area that worsens upon straining. Additional signs and symptoms may include: nausea; vomiting; papilledema; drowsiness; seizures; nystagmus; decreased vision; changes in the level of consciousness (LOC), varying from drowsiness to deep stupor; unequal pupils; personality changes; and specific neurologic deficits which develop over a period of days to weeks. Signs and symptoms will also depend on the location of the abscess.

Tests may include computed tomography (CT) scan, electroencephalogram (EEG), arteriography, and magnetic resonance imaging (MRI). Culture and sensitivity tests of drainage may be done.

Antibiotics are used to treat the condition. The type of antibiotic used will depend on the causative agent. Antibiotics are used for specific organisms. Glucocorticoids and diuretics may be used. Aspiration and drainage of the abscess is almost always required. However, this will depend on the location, size of the abscess, presence of swelling, and lack of clinical response to medical treatment. Anticonvulsants may also be prescribed.

The residuals depend on the location and size of the abscess and may include seizures, paralysis or other specific neurological deficits.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a) [chronic disease].

• It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

• Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a