Brain abscess with ventriculitis

Case contributed by Dr Luu Hanh

Presentation

Fever, headaches.

Patient Data

Age: 55 years
Gender: Male

Rounded lesion in the left temporal lobe which has low signal on T1, ring enhancement, a thin wall with dual rim sign on T2WI/SWI, high signal on DWI, and low signal on ADC. There is extensive perilesional edema. The lesion extends into the left temporal horn of the lateral ventricle.

Layering debris in the occipital horns on FLAIR with restricted diffusion on DWI. Enhancement of the ependymal lining is seen along the left temporal horn of the lateral ventricle.

Case Discussion

The ring-enhancing lesion with central restricted diffusion and dual rim sign at the left temporal lobe consistent with brain abscess. The layering debris in the occipital horns with restricted diffusion and enhancement along the ependymal lining is evidence of rupture into the lateral ventricle with ventriculitis. This is a very serious complication and portends a very poor prognosis. 

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Case information

rID: 85703
Published: 10th Jan 2021
Last edited: 10th Jan 2021
Inclusion in quiz mode: Included
Institution: Ninh Binh general hospital

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