The most frequent presenting symptom of a brain abscess is

• A. Headache.
• B. Nuchal rigidity.
• C. Vomiting.
• D. Seizures.

Answer: (A)

Headache is the most common presenting symptom of a brain abscess because the growing purulent collection inside the brain increases intracranial pressure and irritates the meninges, producing a diffuse, persistent headache that often worsens over time. Fever and general malaise can occur but aren’t universal, and focal neurologic deficits or seizures depend on where the abscess is and may emerge as the condition evolves. Nuchal rigidity points to meningitis due to meningeal irritation, not a brain parenchymal abscess, so it’s not the typical initial sign. Vomiting can happen with increased pressure, but headache remains the most frequent presenting feature.