Presentation
Headache and fever for 4 days.
Patient Data
There is an ill-defined hypodense area involving the anteromedial portion of the left temporal lobe, both sylvian cortex, and the left frontal lobe. A small hyperdense focus has seen in the left sylvian cortex representing small hemorrhage.
There is gyral swelling involving the left temporal lobe, sylvian cortex, and frontal lobe. Some gyral swelling is also noted on the right, although to a lesser degree. A focus of hemorrhage is seen on the left sylvian cortex. The basal ganglia are spared on both sides. No significant parenchymal enhancement in the post-contrast study although patchy meningeal enhancement is seen.
Case Discussion
A teenage female admitted to the emergency room complaining of headache and fever for 4 days, then she had vomiting, poor appetite and decrease cognitive function. The patient was examined and was found to have positive meningeal signs. CT was performed immediately thereafter and MRI was performed the following day. The patient received antiviral medication (Acyclovir) on the same day of admission that continued for two weeks then she was discharged after recovery.
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