Brain abscess with ventriculitis

Case contributed by Dr Amro Omar

Presentation

Fits, fever

Patient Data

Age: 90 years
Gender: Female
  • bilobed oval lesion at the upper right frontal lobe, with hyperdense rim and central hypodensity
  • layering material within occipital horn right lateral ventricle, on background of ventriculomegaly
  • extensive cystic change along bilateral temporal lobes and frontal lobes, as well as diffuse hypodensity of the periventricular white matter

Findings suspicious for right frontal lobe cerebral abscess, likely ventriculitis

  • oval T1 hypointense, T2 hyperintense lesion centered within right superior frontal gyrus. Diffusion-weighted images show central restriction
  • T1/T2 isointense material layering within occipital horn and atrium of right lateral ventricle, which also exhibits diffusion-restriction
  • background of bilateral cystic encephalomalacia and nonspecific T2 hyperintensity throughout most of the periventricular white matter
  • ventriculomegaly

These findings remain consistent with right frontal lobe cerebral abscess and ventriculitis.

Case Discussion

Classic findings of cerebral abscess.

Diffusion-restricting layering material within the ventricle, often within the occipital horn lateral ventricle, is consistent with empyema, indicating ventriculitis.

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Case information

rID: 18789
Published: 20th Jul 2012
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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