Presentation
Slurred speech and ataxia. Off anti-coagulation for the past three days.
Patient Data
There is a heterogenous mass within the right cerebellar hemisphere with surrounding T2/FLAIR hyperintensity compatible with associated vasogenic edema. Internal restricted diffusion and increased susceptibility is suggestive of central necrosis and peripheral hemorrhagic intralesional component.
Mass effect results in effacement of the quadrigeminal plate cistern with the cerebellar hemisphere abutting the medulla. No evidence of transtentorial or tonsillar herniation.
Case Discussion
This is a case of an abscess of the right cerebellum. The patient underwent a right posterior fossa craniotomy for excision of the mass. Histopathologic analysis of was consistent with an abscess. Microbiology revealed Nocardia cyriacigeorgica. He was discharged with a PICC for intravenous home dual antibiotics with intravenous linezolid (resistance to imipenem) and intravenous trimethoprim sulfamethoxazole.
Co-authors:
Abtin Jafroodifar, MD
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