Presentation
Headache and fever. Abnormal CT in the community.
Patient Data
Peripherally enhancing extra axial, intracranial collection overlying left temporal lobe. Peripheral smooth enhancement with adjacent dural thickening and lateral aspect of the collection is in direct continuity with the overlying temporal bone. Cortical buckling and CSF cleft surrounding the collection. Central diffusion restriction within the collection and mastoid effusion. No blooming artefact. T2/FLAIR hyperintensity within the left temporal lobe white matter with extension into the left basal ganglia. No further collections identified.
Grey-white matter differentiation is preserved. Normal appearance of the thalami, brainstem and cerebellum. Prominent CSF space posterior to the cerebellum likely secondary to mega cisterna magna, normal variant. Normal appearance of the ventricular size with no evidence of ventriculitis.
Complete opacification of the left mastoid air cells with significant soft tissue thickening surrounding the mastoid bone. Normal morphology of the membranous labyrinth. Mucosal thickening of the paranasal sinuses.
Subtle linear hypodensity in the left sigmoid sinus suspicious of thrombus.
IMPRESSION
Peripherally enhancing intracranial extra axial collection (27 mm) overlying the left temporal lobe with adjacent mastoiditis.
Possible left sigmoid sinus thrombosis.
Case Discussion
The patient underwent burr hole aspiration in theater which drained pus. ENT inserted a tympanostomy tube and performed a mastoidectomy.
Unable to process the form. Check for errors and try again.